Provider Demographics
NPI:1518997147
Name:SCHAFFER, SUSAN WHELEN (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:WHELEN
Last Name:SCHAFFER
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 1:5875 BREMO RD
Mailing Address - Street 2:MOB SOUTH SUITE G11
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-287-7804
Mailing Address - Fax:804-287-7178
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:MOB SOUTH SUITE G11
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-287-7804
Practice Address - Fax:804-287-7178
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102200841207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06700OtherMEDICARE GROUP
VAC06778OtherGROUP PTAN
VA007364V00Medicare PIN
VAC06778OtherGROUP PTAN