Doctor Name: | MARY ANN SCHULTZ |
NPI Number: | 1417048455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 9841 |
Business Practice Address: | 455 N Sioux Point Rd Dakota Dunes, SD - 570495327 |
Business Phone Number: | 6052177000 |
Business Fax Number: | 6052177015 |
Mailing Address: | 455 Sioux Point Rd, DAKOTA DUNES |
State: | SD |
Postal Code: | 57049 |
Phone Number: | 6052177000 |
Fax Number: | 6052177015 |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 04/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 9841 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |