Individual
MR. KEITH EDWARD SHULTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5111
(315) 703-5079
Mailing address
104 UNION AVE, SUITE 804, SYRACUSE, NY 13203-1843
(315) 703-5049
(315) 703-5079
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/04/2012
Last updated
05/31/2013
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