Provider Demographics
NPI:1134515000
Name:SCHIFFMAN, BRETT ALAN (MD)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:ALAN
Last Name:SCHIFFMAN
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 1:730 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2818
Mailing Address - Country:US
Mailing Address - Phone:219-924-3300
Mailing Address - Fax:219-922-5424
Practice Address - Street 1:9900 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4008
Practice Address - Country:US
Practice Address - Phone:219-924-3300
Practice Address - Fax:219-922-5424
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-155654207XS0106X
390200000X
IN01095150A207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300098782Medicaid
IN1104577646OtherANTHEM