Provider Demographics
NPI:1033286836
Name:SCHAEFER, WALTER C (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:C
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-546-4200
Mailing Address - Fax:410-860-9233
Practice Address - Street 1:560 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-546-4200
Practice Address - Fax:410-860-9233
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0013191207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS0650001OtherBLUE CHOICE
MD7400WCOtherCAREFIRST
MD7400WCOtherCAREFIRST
D74466Medicare UPIN