Provider Demographics
NPI:1194798934
Name:SCHULDHEISZ, SANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:SCHULDHEISZ
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 1:46 TURPEN CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3464
Mailing Address - Country:US
Mailing Address - Phone:606-679-0179
Mailing Address - Fax:606-679-0546
Practice Address - Street 1:46 TURPEN CT
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3464
Practice Address - Country:US
Practice Address - Phone:606-679-0179
Practice Address - Fax:606-679-0546
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31007174400000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64100159Medicaid
KYG56806Medicare UPIN
KY64100159Medicaid