Provider Demographics
NPI:1376692418
Name:SCHAFER, MARIA KATHRYN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:KATHRYN
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7370
Mailing Address - Country:US
Mailing Address - Phone:636-561-7774
Mailing Address - Fax:636-625-8007
Practice Address - Street 1:2315 TECHNOLOGY DR
Practice Address - Street 2:SUITE 107
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7370
Practice Address - Country:US
Practice Address - Phone:636-561-7774
Practice Address - Fax:636-625-8007
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005000400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO670832OtherUNITED HEALTH CARE
MO197615OtherBLUE CROSS BLUE SHIELD
MO764038OtherHEALTHLINK
MOV04977Medicare UPIN