Provider Demographics
NPI:1730697756
Name:SCHULTZ, AMY (MD, MPH)
Entity type:Individual
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First Name:AMY
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MD, MPH
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Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 S JACKSON SQ FL 5
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1457
Mailing Address - Country:US
Mailing Address - Phone:517-205-7433
Mailing Address - Fax:
Practice Address - Street 1:1715 LANSING AVE STE 221
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2193
Practice Address - Country:US
Practice Address - Phone:517-788-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010811882083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine