Provider Demographics
NPI:1881674604
Name:SCHAJA, IAN M (DO)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:M
Last Name:SCHAJA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GLADES RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1419
Mailing Address - Country:US
Mailing Address - Phone:561-939-5500
Mailing Address - Fax:561-939-0555
Practice Address - Street 1:501 GLADES RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1419
Practice Address - Country:US
Practice Address - Phone:561-939-5500
Practice Address - Fax:561-939-0555
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007011207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252920300Medicaid
FL57425OtherBCBS
FL57425TMedicare PIN
FL57425VMedicare PIN
FL57425UMedicare PIN
FL57425RMedicare PIN
FLG40878Medicare UPIN
FL57425OtherBCBS