Provider Demographics
NPI:1356313936
Name:SCHAEFER, ALBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
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 1:1230 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-4536
Mailing Address - Country:US
Mailing Address - Phone:970-778-5489
Mailing Address - Fax:
Practice Address - Street 1:1230 WHITE AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-4536
Practice Address - Country:US
Practice Address - Phone:970-778-5489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446245207VM0101X
SC27233207VM0101X
CODR.0039403207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO35150041Medicaid
FL002371200Medicaid
SC272332Medicaid
SC272332Medicaid
SCH040628552Medicare ID - Type Unspecified
FLDK842ZMedicare PIN