Provider Demographics
NPI:1073551321
Name:SCHAEFER, CRAIG J (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:J
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:PO BOX 64834
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4834
Mailing Address - Country:US
Mailing Address - Phone:443-481-6573
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:ACUTE CARE PAVILION
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:443-481-1360
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026558208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1907265OtherAETNA HMO
222191OtherKAISER PERMANENTE
39979104OtherBCBS MD
MD459341300Medicaid
00006OtherBCBS FEDERAL
VA0101026558OtherLICENSE
019127OtherJOHNS HOPKINS HEALTHCARE PRIORTY PARTNERS, EHP AND USF
4386454OtherAETNA PPO
019127OtherJOHNS HOPKINS HEALTHCARE PRIORTY PARTNERS, EHP AND USF
VA0101026558OtherLICENSE
MD459341300Medicaid
D74435Medicare UPIN
G02440V01Medicare PIN