Provider Demographics
NPI:1821066150
Name:SCHAEFFER, KARL IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:IRA
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6372 WINDRUSH LANE
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004
Mailing Address - Country:US
Mailing Address - Phone:614-866-4089
Mailing Address - Fax:614-868-9996
Practice Address - Street 1:5969 E. BROAD ST.
Practice Address - Street 2:SUITE401
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:614-868-1160
Practice Address - Fax:614-868-9996
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3503611S207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2462062Medicaid
OHSC0434632Medicare ID - Type Unspecified
OHA76120Medicare UPIN