Healthcare Provider Details

I. General information

NPI: 1134192339
Provider Name (Legal Business Name): SANFORD DAVID SCHULHOFER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: S. DAVID SCHULHOFER D.P.M.

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 CALLE DE LA VUELTA C103
SANTA FE NM
87505-4742
US

IV. Provider business mailing address

2100 CALLE DE LA VUELTA C103
SANTA FE NM
87505-4742
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-5014
  • Fax: 505-982-2687
Mailing address:
  • Phone: 505-982-5014
  • Fax: 505-982-2687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number253
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number253
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: