Organization Name: | GREGORY N SCHAEFER M.D., P.A. |
NPI Number: | 1073874780 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREGORY N SCHAEFER (DOCTOR/OWNER) |
Mailing Address: | 1603 12th Ave Rd Suite B Nampa |
State: | ID US |
Postal Code: | 836867712 |
Phone Number: | 2084672400 |
Fax Number: | 2084676416 |
NPI Enumeration Date: | 05/30/2012 |
NPI Last Update Date: | 05/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | M4187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |