Individual
DR. STACY NORMAN SCHULZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 CARLANNA LAKE RD STE 201, BOX 6755, KETCHIKAN, AK 99901-5642
(907) 247-3301
(907) 247-3306
Mailing address
PO BOX 6755, 212 CARLANNA RD #201, KETCHIKAN, AK 99901-1755
(907) 247-3301
(907) 247-3306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2604
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2604
STATE MD LICENSE
AK
05
—
MD13202
—
AK
Enumeration date
08/13/2006
Last updated
10/17/2007
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