Provider Demographics
NPI:1073727079
Name:SCHAFER, KATHERINE R (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:R
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:WAKE FOREST BAPTIST MEDICAL CENTER INFECTIOUS DISEASES
Mailing Address - Street 2:MEDICAL CENTER BOULEVARD
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-1042
Mailing Address - Country:US
Mailing Address - Phone:336-716-4584
Mailing Address - Fax:336-716-3825
Practice Address - Street 1:WAKE FOREST BAPTIST MEDICAL CENTER INFECTIOUS DISEASES
Practice Address - Street 2:MEDICAL CENTER BOULEVARD
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157
Practice Address - Country:US
Practice Address - Phone:336-716-4584
Practice Address - Fax:336-716-3825
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101244544207R00000X
NC2013-01558207RI0200X
VA0116017490390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1073727079Medicaid