Healthcare Provider Details

I. General information

NPI: 1801986856
Provider Name (Legal Business Name): JEFFREY HOWARD SCHIFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5534 MEDICAL CIR
MADISON WI
53719-1202
US

IV. Provider business mailing address

5534 MEDICAL CIR
MADISON WI
53719-1202
US

V. Phone/Fax

Practice location:
  • Phone: 608-274-0355
  • Fax:
Mailing address:
  • Phone: 608-274-0355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number28073-020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number28073-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: