Provider Demographics
| NPI: | 1871573568 |
|---|---|
| Name: | SCHULT, ALEXANDER A (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | ALEXANDER |
| Middle Name: | A |
| Last Name: | SCHULT |
| Suffix: | |
| Gender: | M |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 856 J CLYDE MORRIS BLVD STE A |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NEWPORT NEWS |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 23601-1318 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 757-316-5800 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 20486 MARKET STREET |
| Practice Address - Street 2: | |
| Practice Address - City: | ONANCOCK |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 23417-2341 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 757-302-2700 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2006-01-19 |
| Last Update Date: | 2022-10-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| VA | 0101222053 | 207RC0200X, 207RP1001X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
| No | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| VA | 016114C54 | Medicare PIN | |
| H40384 | Medicare UPIN | ||
| VA | P00713154 | Medicare PIN |