Provider Demographics
NPI:1871887067
Name:SCHULTHEIS, CAITLIN VAN SICKLER (MD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:VAN SICKLER
Last Name:SCHULTHEIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4199 GATEWAY BLVD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8940
Mailing Address - Country:US
Mailing Address - Phone:812-471-0045
Mailing Address - Fax:812-471-0120
Practice Address - Street 1:4199 GATEWAY BLVD
Practice Address - Street 2:SUITE 2500
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8940
Practice Address - Country:US
Practice Address - Phone:812-471-0045
Practice Address - Fax:812-471-0120
Is Sole Proprietor?:No
Enumeration Date:2011-06-05
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 15959207V00000X
IN01074711A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201296680Medicaid
IN637070001Medicare PIN
IN637080001Medicare PIN