Individual
DANIEL STULTZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 E BEAUREGARD AVE, SAN ANGELO, TX 76903-5919
(325) 658-1511
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E4707
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B26752
UPIN
TX
Enumeration date
11/04/2005
Last updated
07/09/2007
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