Provider Demographics
NPI:1942207626
Name:SCHOFER, VIRGINIA A
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:SCHOFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 BLANDING ST
Mailing Address - Street 2:STE 203
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2967
Mailing Address - Country:US
Mailing Address - Phone:803-939-0711
Mailing Address - Fax:803-753-2873
Practice Address - Street 1:1410 BLANDING ST
Practice Address - Street 2:STE 203
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2967
Practice Address - Country:US
Practice Address - Phone:803-939-0711
Practice Address - Fax:803-753-2873
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA02138234Medicare ID - Type Unspecified
U22365Medicare UPIN