Provider Demographics
NPI:1538265004
Name:SCHULTZ, EDWARD M (DC)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:M
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 RAEFORD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3049
Mailing Address - Country:US
Mailing Address - Phone:910-487-1300
Mailing Address - Fax:910-487-0030
Practice Address - Street 1:5511 RAEFORD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3049
Practice Address - Country:US
Practice Address - Phone:910-487-1300
Practice Address - Fax:910-487-0030
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7908809Medicaid
NC08809OtherBCBS OF NC
T64558Medicare UPIN
NC7908809Medicaid