1902138993 NPI number — HOWARD L. SCHULTHEISS, JR., DPM, P.A.

Table of content: (NPI 1902138993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902138993 NPI number — HOWARD L. SCHULTHEISS, JR., DPM, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARD L. SCHULTHEISS, JR., DPM, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HARFORD LOWER EXTREMITY SPECIALISTS
Provider Other Organization Name Type Code:
3
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:
1902138993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
437 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEL AIR
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21014-3919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-836-0131
Provider Business Mailing Address Fax Number:
410-836-8594

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
437 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEL AIR
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21014-3919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-836-0131
Provider Business Practice Location Address Fax Number:
410-836-8594
Provider Enumeration Date:
02/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SCHULTHEISS
Authorized Official First Name:
VICKIE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
MEDICAL ADMINISTRATOR
Authorized Official Telephone Number:
410-836-0131

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  01108 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1852436003 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: R709 . This is a "BCBS DC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2700271 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 158068000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: T324HL . This is a "BCBS MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0468265 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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