1548258387 NPI number — ANGELA MARIE SCHULTZ MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548258387 NPI number — ANGELA MARIE SCHULTZ MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SCHULTZ

Provider First Name:

ANGELA

Provider Middle Name:

MARIE

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

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:

1548258387

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/19/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

8118 CARPENTER RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

FLUSHING

Provider Business Mailing Address State Name:

MI

Provider Business Mailing Address Postal Code:

48433-1360

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

810-410-8151

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

8118 CARPENTER RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

FLUSHING

Provider Business Practice Location Address State Name:

MI

Provider Business Practice Location Address Postal Code:

48433-1360

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

810-410-8151

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

10/06/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207QA0401X , with the licence number:  4301066433 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 0995378 . This is a "HEALTHPLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 1011386 . This is a "HEALTH ADVANTAGE PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 381908328 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 060 . This is a "COMMUNITY CHOICE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 1914936 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 4549910 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
• Identifier: 115400 . This is a "GREAT LAKES HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 7729026 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: P31368F . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 1011386 . This is a "MCLAREN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 080G310660 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 381908328 . This is a "HCAP" identifier . This identifiers is of the category "OTHER".
• Identifier: 4549910 . This is a "MOLINA HEALTH CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".