Provider Demographics
NPI:1659488609
Name:SCHAFF, STEVEN RAY (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
Last Name:SCHAFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WILDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3933
Mailing Address - Country:US
Mailing Address - Phone:517-789-8119
Mailing Address - Fax:517-789-6276
Practice Address - Street 1:2700 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3933
Practice Address - Country:US
Practice Address - Phone:517-789-8119
Practice Address - Fax:517-789-6276
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002927152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5348270001OtherADMINISTAR FEDERAL
MI5348270003OtherADMINISTAR FEDERAL
MI2220038OtherPHP
MI24031OtherSPECTERA
MI24033OtherSPECTERA
MI5177877900OtherVSP
MIMI2927OtherEYEMED
MISC1628192OtherCLARITY VISION
MI30416OtherHEALTH PLAN OF MI
MISC1628188OtherCLARITY VISION
MIVC380005OtherMCARE
MI900C811090OtherBCBSM
MIP00244736OtherRAILROAD MEDICARE
MI900C811080OtherBCBSM
MI30416OtherHEALTH PLAN OF MI
MIT33222Medicare UPIN