Provider Demographics
NPI:1780657569
Name:SCHAEFFER, MICHAEL STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEVEN
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2050 N HAGGERTY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187
Mailing Address - Country:US
Mailing Address - Phone:734-981-1086
Mailing Address - Fax:734-981-5094
Practice Address - Street 1:2050 N HAGGERTY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187
Practice Address - Country:US
Practice Address - Phone:734-981-1086
Practice Address - Fax:734-981-5094
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104521614Medicaid
110227238OtherRAILROAD MEDICARE
110227238OtherRAILROAD MEDICARE
MIH10776Medicare UPIN