Provider Demographics
NPI:1013930015
Name:SCHAFER, SHARON M (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 FOLKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3154
Mailing Address - Country:US
Mailing Address - Phone:248-879-6246
Mailing Address - Fax:
Practice Address - Street 1:5741 FOLKSTONE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3154
Practice Address - Country:US
Practice Address - Phone:248-879-6246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066605207L00000X
MI4301036655207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
04097OtherPARAMOUNT
MI4472841-10Medicaid
P00366270OtherRAILROAD MEDICARE
OH2674495Medicaid
MI4505989-10Medicaid
MI4587803-10Medicaid
MI4386224-10Medicaid
MI0M61020006Medicare ID - Type Unspecified
MI0N60380006Medicare ID - Type Unspecified
MIP00000479Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MI4587803-10Medicaid
04097OtherPARAMOUNT
MI4505989-10Medicaid
OHSC4187411Medicare PIN
P00366270OtherRAILROAD MEDICARE
MIA76671Medicare UPIN