Individual
DR. MICHAELA SCHULTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 371-8772
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-10592
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119624
MEDICARE PTAN
ID
Enumeration date
05/07/2007
Last updated
03/14/2016
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