Basic Information
| Provider Information | |||||||||
| NPI: | 1174503833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHULTE | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | J A | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10400 EATON PLACE | ||||||||
| Address2: | #410 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033595160 | ||||||||
| FaxNumber: | 7033839574 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 PIDGEON HILL DR | ||||||||
| Address2: | #202 | ||||||||
| City: | STERLING | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034441144 | ||||||||
| FaxNumber: | 7034446679 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 0101025377 | VA | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | D0016866 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.