Individual
DR. GARY L. SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
202 10TH ST SE, CEDAR RAPIDS, IA 52403
(563) 556-3944
Mailing address
PO BOX 1086, DUBUQUE, IA 52004-1086
(563) 556-3944
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036-104675
IL
2085R0001X
Radiation Oncology Physician
Primary
074594
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003166645A
—
GA
05
—
1538177241 1
—
IL
Enumeration date
08/04/2006
Last updated
03/20/2019
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