Provider Demographics
NPI:1114771375
Name:SCHAFER, DAWN MCGRATH
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MCGRATH
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6318
Mailing Address - Country:US
Mailing Address - Phone:515-554-0154
Mailing Address - Fax:
Practice Address - Street 1:5620 ASPEN DR
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6318
Practice Address - Country:US
Practice Address - Phone:515-554-0154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA102WW9778172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver