Provider Demographics
NPI:1073505822
Name:SCHANFIELD, PAUL M (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:SCHANFIELD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1650 BEAM AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1192
Mailing Address - Country:US
Mailing Address - Phone:651-221-9051
Mailing Address - Fax:651-223-5220
Practice Address - Street 1:1650 BEAM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1192
Practice Address - Country:US
Practice Address - Phone:651-221-9051
Practice Address - Fax:651-223-5220
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2011-01-05
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Provider Licenses
StateLicense IDTaxonomies
MN210642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN034082100Medicaid
MNA93698Medicare UPIN
MN130000047Medicare ID - Type Unspecified