Healthcare Provider Details

I. General information

NPI: 1033479720
Provider Name (Legal Business Name): MARIE ANN SCHAEFER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 TRANSPORTATION BLVD
GARFIELD HEIGHTS OH
44125-5371
US

IV. Provider business mailing address

26900 CEDAR RD BD10
BEACHWOOD OH
44122-1191
US

V. Phone/Fax

Practice location:
  • Phone: 216-425-7257
  • Fax: 216-771-5873
Mailing address:
  • Phone: 216-839-3000
  • Fax: 216-839-3910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.123858
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35.123858
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: