Provider Demographics
NPI:1598873572
Name:SCHAFLE, MARIE D (MD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:D
Last Name:SCHAFLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1270 SUZANNE DR.
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANGELS CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95222-9744
Mailing Address - Country:US
Mailing Address - Phone:209-736-0100
Mailing Address - Fax:209-736-0128
Practice Address - Street 1:1270 SUZANNE DR.
Practice Address - Street 2:SUITE A
Practice Address - City:ANGELS CAMP
Practice Address - State:CA
Practice Address - Zip Code:95222-9744
Practice Address - Country:US
Practice Address - Phone:209-736-0100
Practice Address - Fax:209-736-0128
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA26737204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine