Healthcare Provider Details

I. General information

NPI: 1396741666
Provider Name (Legal Business Name): ROBERT F SCHAEFER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17050 BAXTER RD CHESTERFIELD SURGERY CENTER, LLC, SUITE 110
CHESTERFIELD MO
63005-1422
US

IV. Provider business mailing address

351 CONSORT DR
BALLWIN MO
63011-4439
US

V. Phone/Fax

Practice location:
  • Phone: 636-537-0122
  • Fax: 636-537-0480
Mailing address:
  • Phone: 636-386-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberR3K50
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: