Provider Demographics
NPI:1982673158
Name:SCHAFER, HOWARD L (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:L
Last Name:SCHAFER
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:PO BOX 5545
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-5545
Mailing Address - Country:US
Mailing Address - Phone:765-448-8000
Mailing Address - Fax:
Practice Address - Street 1:938 MEZZANINE DR STE B
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-8641
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-838-6302
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010319452A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000182167OtherANTHEM PROVIDER NUMBER
IN26472OtherPHCS PID NUMBER
IN100350950Medicaid
IN10825890OtherCAQH NUMBER
INSC17922016Medicaid
IN26472OtherPHCS PID NUMBER
INSC17922016Medicaid
IN100350950Medicaid
IN224390MMMedicare PIN
IN815520PPPPMedicare PIN
IN815460BMedicare PIN
IN10825890OtherCAQH NUMBER