Healthcare Provider Details

I. General information

NPI: 1457344665
Provider Name (Legal Business Name): WILLIAM ELMER SCHAEFFER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 NORMAN DR
LEBANON PA
17042-7497
US

IV. Provider business mailing address

755 NORMAN DR
LEBANON PA
17042-7497
US

V. Phone/Fax

Practice location:
  • Phone: 717-273-6706
  • Fax: 717-273-1435
Mailing address:
  • Phone: 717-273-6706
  • Fax: 717-273-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD025316L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: