Provider Demographics
NPI:1376629410
Name:SCHAFER, PAMELA M (PA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5335 DISCOVERY PARK BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188
Mailing Address - Country:US
Mailing Address - Phone:757-345-4500
Mailing Address - Fax:757-345-4501
Practice Address - Street 1:5335 DISCOVERY PARK BLVD
Practice Address - Street 2:STE B
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-345-4500
Practice Address - Fax:757-345-4501
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110840383363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP55447Medicare UPIN