1609047000 NPI number — LOIS SCHAFER PHD & ASSOCIATES, L.L.C.

Table of content: (NPI 1609047000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609047000 NPI number — LOIS SCHAFER PHD & ASSOCIATES, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOIS SCHAFER PHD & ASSOCIATES, L.L.C.
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:
1609047000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43750 GARFIELD RD
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
CLINTON TWP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48038-1135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-226-6855
Provider Business Mailing Address Fax Number:
586-226-6880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43750 GARFIELD RD
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
CLINTON TWP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48038-1135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-226-6855
Provider Business Practice Location Address Fax Number:
586-226-6880
Provider Enumeration Date:
03/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAFER
Authorized Official First Name:
LOIS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
586-226-6855

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  6301008020 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 143624 . This is a "PRIORITY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7487278 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P111686 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: G2157173 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 11409 . This is a "M-CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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