Provider Demographics
NPI:1134192339
Name:SCHULHOFER, SANFORD DAVID (DPM)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:DAVID
Last Name:SCHULHOFER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:S.
Other - Middle Name:DAVID
Other - Last Name:SCHULHOFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2100 CALLE DE LA VUELTA
Mailing Address - Street 2:C103
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4742
Mailing Address - Country:US
Mailing Address - Phone:505-982-5014
Mailing Address - Fax:505-982-2687
Practice Address - Street 1:2100 CALLE DE LA VUELTA
Practice Address - Street 2:C103
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4742
Practice Address - Country:US
Practice Address - Phone:505-982-5014
Practice Address - Fax:505-982-2687
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM253213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMS2165Medicaid
1307170001Medicare NSC
NMU55924Medicare UPIN