Healthcare Provider Details

I. General information

NPI: 1568880722
Provider Name (Legal Business Name): STEPHANIE SCHRAGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE SCHAFER

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MEADOW CREEK DR STE. 106
WESTMINSTER MD
21158-9426
US

IV. Provider business mailing address

22 BROOKEBURY DR APT 2A
REISTERSTOWN MD
21136-2821
US

V. Phone/Fax

Practice location:
  • Phone: 410-862-5487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA0000546
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: