Provider Demographics
NPI:1912987363
Name:SCHULTZ, DAVID E II (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:SCHULTZ
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4933 PLAZA EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2813
Mailing Address - Country:US
Mailing Address - Phone:812-479-6907
Mailing Address - Fax:812-479-6967
Practice Address - Street 1:1231 WASHINGTON SQ
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-6807
Practice Address - Country:US
Practice Address - Phone:812-479-6907
Practice Address - Fax:812-479-6967
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01050928A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200247960Medicaid
INH05690Medicare UPIN
1912987363Medicare PIN
IN200247960Medicaid