Healthcare Provider Details

I. General information

NPI: 1003074352
Provider Name (Legal Business Name): WILLIAM EDWARD SCHAAF JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE S DEPARTMENT OF RADIOLOGY
SAINT PETERSBURG FL
33701-4634
US

IV. Provider business mailing address

601 5TH ST S 5TH FLOOR; DEPT. 6941
SAINT PETERSBURG FL
33701
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-3318
  • Fax:
Mailing address:
  • Phone: 727-767-8480
  • Fax: 727-767-8420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35091450
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME 104296
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberME104296
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: