Provider Demographics
NPI:1902138993
Name:HOWARD L. SCHULTHEISS, JR., DPM, P.A.
Entity type:Organization
Organization Name:HOWARD L. SCHULTHEISS, JR., DPM, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHULTHEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MT ASCP
Authorized Official - Phone:410-836-0131
Mailing Address - Street 1:437 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3919
Mailing Address - Country:US
Mailing Address - Phone:410-836-0131
Mailing Address - Fax:410-836-8594
Practice Address - Street 1:437 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3919
Practice Address - Country:US
Practice Address - Phone:410-836-0131
Practice Address - Fax:410-836-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01108213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1852436003OtherCIGNA
MDR709OtherBCBS DC
MD2700271OtherUNITED HEALTHCARE
MD158068000Medicaid
MDT324HLOtherBCBS MD
MD0468265OtherAETNA
MDR709OtherBCBS DC
MDT324HLOtherBCBS MD
MD0468265OtherAETNA