Provider Demographics
NPI:1942460878
Name:SCHAEFER, PAUL M (M D)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:M D
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Other - Credentials:
Mailing Address - Street 1:4900 WYALUSING AVE
Mailing Address - Street 2:COMMUNITY COUNCIL HEALTH SYSTEMS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-5127
Mailing Address - Country:US
Mailing Address - Phone:215-473-7033
Mailing Address - Fax:215-878-9199
Practice Address - Street 1:4900 WYALUSING AVE
Practice Address - Street 2:COMMUNITY COUNCIL HEALTH SYSTEMS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-5127
Practice Address - Country:US
Practice Address - Phone:215-473-7033
Practice Address - Fax:215-878-9199
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-037197E2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry