Provider Demographics
NPI:1912969932
Name:SCHAFFER, BRAD ROBB (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:ROBB
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 NORTHERN PIKE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2713
Mailing Address - Country:US
Mailing Address - Phone:412-374-8897
Mailing Address - Fax:412-374-8897
Practice Address - Street 1:4205 NORTHERN PIKE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2713
Practice Address - Country:US
Practice Address - Phone:412-374-8897
Practice Address - Fax:412-374-8897
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005623L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA306382OtherUPMC HEALTH PLAN
PASC060012OtherMEDICARE
PA000191415OtherBLUE SHIELD
PASC060012OtherMEDICARE
PA306382OtherUPMC HEALTH PLAN