Provider Demographics
NPI:1922305127
Name:SCHAEFER, ERIK M
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:M
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CAMP MUJUK
Mailing Address - Street 2:UNIT 15017
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96218-0173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CAMP MUJUK
Practice Address - Street 2:UNIT 15017
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96218-0173
Practice Address - Country:US
Practice Address - Phone:8227-917-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman