1396757670 NPI number — THOMAS L. SCHAEFER, MD

Table of content: (NPI 1396757670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396757670 NPI number — THOMAS L. SCHAEFER, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS L. SCHAEFER, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396757670
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6011 BAPTIST RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15236-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-851-1200
Provider Business Mailing Address Fax Number:
412-851-1234

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6011 BAPTIST RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15236-3305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-851-1200
Provider Business Practice Location Address Fax Number:
412-851-1234
Provider Enumeration Date:
08/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAEFER
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
412-851-1200

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD02332E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 80170 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 80170 . This is a "HEALTH AMERICA/HEALTH ASS" identifier . This identifiers is of the category "OTHER".
  • Identifier: CK8673 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014504 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 136805 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001504979 . This is a "HIGHMARK BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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