Provider Demographics
NPI:1124100029
Name:SCHULTZ, JOHN STEVEN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVEN
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4632 GENESYS PARKWAY
Mailing Address - Street 2:MEDICAL REHABILITATION GROUP PC
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8067
Mailing Address - Country:US
Mailing Address - Phone:810-606-7181
Mailing Address - Fax:810-606-7174
Practice Address - Street 1:4632 GENESYS PARKWAY
Practice Address - Street 2:MEDICAL REHABILITATION GROUP PC
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8067
Practice Address - Country:US
Practice Address - Phone:810-606-7181
Practice Address - Fax:810-606-7174
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301405898208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1997808Medicaid
MIB48473Medicare UPIN
M61910Medicare PIN