Provider Demographics
NPI:1376022061
Name:SCHAEFER, MAXIMILIAN SEBASTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MAXIMILIAN
Middle Name:SEBASTIAN
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 1:330 BROOKLINE AVE
Mailing Address - Street 2:YAMINS 2ND FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-3110
Mailing Address - Fax:617-667-5050
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:YAMINS 2ND FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-3110
Practice Address - Fax:617-667-5050
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2019-03-27
Deactivation Date:2019-03-25
Deactivation Code:
Reactivation Date:2019-03-25
Provider Licenses
StateLicense IDTaxonomies
MA277651207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology