Provider Demographics
NPI:1609124049
Name:SCHAAF, PETER JAMES
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JAMES
Last Name:SCHAAF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9243 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-8308
Mailing Address - Country:US
Mailing Address - Phone:480-986-4696
Mailing Address - Fax:480-986-4697
Practice Address - Street 1:9243 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-8308
Practice Address - Country:US
Practice Address - Phone:480-986-4696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist