Provider Demographics
NPI:1104908383
Name:SHULTZ, MARGARITA M (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:M
Last Name:SHULTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MILLERSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-6614
Mailing Address - Country:US
Mailing Address - Phone:717-393-5892
Mailing Address - Fax:717-393-3774
Practice Address - Street 1:1300 MILLERSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-6614
Practice Address - Country:US
Practice Address - Phone:717-393-5892
Practice Address - Fax:717-393-3774
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-011168E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B33587Medicare UPIN
PA026957J7GMedicare ID - Type Unspecified