Basic Information
| Provider Information | |||||||||
| NPI: | 1568436301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHULTZ | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 3686 GRANDVIEW PKWY | ||||||||
| Address2: | STE 720 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352433408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059394512 | ||||||||
| FaxNumber: | 2059394519 | ||||||||
| Practice Location | |||||||||
| Address1: | 3686 GRANDVIEW PKWY STE 720 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352433408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0529717563 | ||||||||
| FaxNumber: | 2059717572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2006 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD00019143 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 051522377 | 01 | AL | BCBS PROVIDER NUMBER | OTHER | 051522377 | 05 | AL | MEDICAID | P00138436 | 01 | AL | RRMCR PROVIDER NUMBER | OTHER |