Provider Demographics
NPI:1396198172
Name:SCHAFER, KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1050 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1548
Mailing Address - Country:US
Mailing Address - Phone:732-283-2663
Mailing Address - Fax:732-283-2661
Practice Address - Street 1:1050 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1548
Practice Address - Country:US
Practice Address - Phone:732-283-2663
Practice Address - Fax:732-283-2661
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA11351200207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery