Provider Demographics
NPI:1427023266
Name:SCHAEFFER, TAMMI H (DO)
Entity Type:Individual
Prefix:
First Name:TAMMI
Middle Name:H
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3134
Practice Address - Country:US
Practice Address - Phone:207-662-7046
Practice Address - Fax:207-662-7054
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42694207P00000X, 207PT0002X
MELT13096207PT0002X
MELT3096207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28605039Medicaid
CO28605039Medicaid
MESCHAEFFERTAMMedicare PIN
ME003486201Medicare PIN
COC552078Medicare PIN