Provider Demographics
NPI:1114223419
Name:SCHULTZE, EDWARD WALTON (EDD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WALTON
Last Name:SCHULTZE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4401
Mailing Address - Country:US
Mailing Address - Phone:301-309-8200
Mailing Address - Fax:301-309-9667
Practice Address - Street 1:208 MONROE ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4401
Practice Address - Country:US
Practice Address - Phone:301-309-8200
Practice Address - Fax:301-309-9667
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional