Provider Demographics
NPI:1649242801
Name:SCHAEFFER, SCOTT J (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:J
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5311 LIMESTONE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808
Mailing Address - Country:US
Mailing Address - Phone:302-234-9109
Mailing Address - Fax:302-234-9042
Practice Address - Street 1:5311 LIMESTONE RD
Practice Address - Street 2:STE 201
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-234-9109
Practice Address - Fax:302-234-9042
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10003253208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
080045914OtherRAILROAD MEDICARE
F20771Medicare UPIN
DE714261S36Medicare Oscar/Certification