Basic Information
| Provider Information | |||||||||
| NPI: | 1568543809 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHULZ | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 725 | ||||||||
| Address2: | |||||||||
| City: | KEARNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688480725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088657181 | ||||||||
| FaxNumber: | 3088652929 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 E 31ST ST | ||||||||
| Address2: | |||||||||
| City: | KEARNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688472926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088657100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 15239 | NE | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 47037975512 | 05 | NE | MEDICAID |