1386709160 NPI number — DR. ED SCHULTE PHD

Table of content: DR. ED SCHULTE PHD (NPI 1386709160)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386709160 NPI number — DR. ED SCHULTE PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULTE
Provider First Name:
ED
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386709160
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
618 E 1714TH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALDWIN CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66006-8229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-594-4165
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2947 SW WANAMAKER DR STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-5347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-354-0767
Provider Business Practice Location Address Fax Number:
785-354-9582
Provider Enumeration Date:
12/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  00870 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00870 . This is a "SLP LICENSE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com