Healthcare Provider Details

I. General information

NPI: 1275507444
Provider Name (Legal Business Name): EDWARD WILLIAM SCHAEFER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR SUITE 310
COLUMBIA MD
21044-3260
US

IV. Provider business mailing address

10710 CHARTER DR SUITE 310
COLUMBIA MD
21044-3260
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-5944
  • Fax: 410-997-1720
Mailing address:
  • Phone: 410-997-5944
  • Fax: 410-997-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD18457
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberD00018457
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: