Doctor Name: | PAMELA JO SHULTZ |
NPI Number: | 1043373426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 31954 |
Business Practice Address: | 15251 Pleasant Valley Rd Re 16 Center City, MN - 550129640 |
Business Phone Number: | 6512134761 |
Business Fax Number: | 6512134534 |
Mailing Address: | 15251 Pleasant Valley Rd, Re 16 CENTER CITY |
State: | MN |
Postal Code: | 550129640 |
Phone Number: | 6512134761 |
Fax Number: | 6512134534 |
NPI Enumeration Date: | 12/18/2006 |
NPI Last Update Date: | 07/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RA0401X |
License Number: | 31954 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |