NPI 1043835440

Michael Dale Shoultz, PHD

Practitioner Specialist Madison, WI

Practice location

Address: 2622 Hoard St, Madison, WI 53704-4827
Phone: (608) 345-8277
Mailing address: 314 N Lincolnway, North Aurora, IL 60542-1132

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 137960 (WI)

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Registry record

NPI: 1043835440
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jun 2020
Record last updated: 11 Jun 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.