Provider Demographics
NPI:1588834782
Name:DAVID SCHAEFER, M.D., P.C.
Entity Type:Organization
Organization Name:DAVID SCHAEFER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-656-5800
Mailing Address - Street 1:455 S LIVERNOIS RD
Mailing Address - Street 2:SUITE B 21
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2578
Mailing Address - Country:US
Mailing Address - Phone:248-656-5800
Mailing Address - Fax:248-656-5802
Practice Address - Street 1:455 S LIVERNOIS RD
Practice Address - Street 2:SUITE B 21
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2578
Practice Address - Country:US
Practice Address - Phone:248-656-5800
Practice Address - Fax:248-656-5802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI036473261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0639537OtherMEDICARE PROVIDER NUMBER
MI0639537OtherMEDICARE PROVIDER NUMBER