Provider Demographics
NPI:1205813458
Name:SCHAEFER, BRADLEY STEPHEN (HEALTH SERV TECH)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:STEPHEN
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:HEALTH SERV TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 2 ST SW
Mailing Address - Street 2:USCG HQ COMOT GG 1122
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:907-487-5757
Mailing Address - Fax:907-487-5360
Practice Address - Street 1:BLDG N46 CAPE SARICHEF
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99619-5002
Practice Address - Country:US
Practice Address - Phone:907-487-5757
Practice Address - Fax:907-487-5360
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other