Provider Demographics
NPI:1508807645
Name:SCHAEFER, DAVID G (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:95 CHALMERS DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1843
Mailing Address - Country:US
Mailing Address - Phone:248-652-8943
Mailing Address - Fax:248-652-8943
Practice Address - Street 1:95 CHALMERS DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1843
Practice Address - Country:US
Practice Address - Phone:248-652-8943
Practice Address - Fax:248-652-8943
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2015-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI036473207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A74673Medicare UPIN
0639537Medicare ID - Type Unspecified