Provider Demographics
NPI:1043373426
Name:SHULTZ, PAMELA JO (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JO
Last Name:SHULTZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8603 CHERRYWOOD TRL N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042
Mailing Address - Country:US
Mailing Address - Phone:612-240-0873
Mailing Address - Fax:
Practice Address - Street 1:1700 UNIVERSITY AVE W FL 6
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3727
Practice Address - Country:US
Practice Address - Phone:651-232-2273
Practice Address - Fax:651-232-4953
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2023-06-20
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Provider Licenses
StateLicense IDTaxonomies
MN31954207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine