Healthcare Provider Details

I. General information

NPI: 1881891224
Provider Name (Legal Business Name): DAVID S SCHAEFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 W 200 N STE 200
SAINT GEORGE UT
84770-4505
US

IV. Provider business mailing address

1969 W 450 S
SAINT GEORGE UT
84770-5854
US

V. Phone/Fax

Practice location:
  • Phone: 435-634-5600
  • Fax: 435-986-8702
Mailing address:
  • Phone: 435-674-3583
  • Fax: 435-674-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7825773-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: