Provider Demographics
NPI:1013940717
Name:SCHAFFER, SCOTT RICHARD (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:RICHARD
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:406 LIPPINCOTT DR STE F
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4168
Practice Address - Country:US
Practice Address - Phone:856-435-9100
Practice Address - Fax:856-435-9112
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04481800207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
598552SK3Medicare PIN
077356Medicare Oscar/Certification
MA44818Medicare UPIN