Provider Demographics
NPI:1144362997
Name:HOWARD L. SCHULTHEISS, JR, DPM, PA
Entity type:Organization
Organization Name:HOWARD L. SCHULTHEISS, JR, DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
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:2007-02-12
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01108332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0859210001Medicare NSC