Provider Demographics
NPI:1447645262
Name:SCHULTZ, MYLES LA VERNE (MD)
Entity type:Individual
Prefix:
First Name:MYLES
Middle Name:LA VERNE
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 JAN SEBASTIAN DR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2377
Mailing Address - Country:US
Mailing Address - Phone:774-205-2400
Mailing Address - Fax:774-338-5388
Practice Address - Street 1:2 JAN SEBASTIAN DR
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2377
Practice Address - Country:US
Practice Address - Phone:774-205-2400
Practice Address - Fax:774-338-5388
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2024-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA277194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine