Provider Demographics
NPI:1063499879
Name:SCHAFFER, TODD W (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:W
Last Name:SCHAFFER
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:
Practice Address - Street 1:3318 N 14TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1614
Practice Address - Country:US
Practice Address - Phone:701-323-8300
Practice Address - Fax:701-323-8305
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9433207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND25689OtherBLUE CROSS BLUE SHIELD ND
ND81335Medicaid
NDP00246702OtherRAILROAD MEDICARE
ND12618Medicaid
ND407241040375OtherPREFERREDONE
ND12618Medicaid
ND81335Medicaid