Healthcare Provider Details

I. General information

NPI: 1821366535
Provider Name (Legal Business Name): PETER E SCHAFFER DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N OLD WOODWARD AVE SUITE 202
BIRMINGHAM MI
48009-1324
US

IV. Provider business mailing address

600 N OLD WOODWARD AVE SUITE 202
BIRMINGHAM MI
48009-1324
US

V. Phone/Fax

Practice location:
  • Phone: 248-594-3338
  • Fax:
Mailing address:
  • Phone: 248-594-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5901000620
License Number StateMI

VIII. Authorized Official

Name: DR. PETER E SCHAFFER
Title or Position: SOLE PROPRIETOR
Credential: DPM
Phone: 248-594-3338