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General NPI Number Information
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NPI Number | 1477885135
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Entity Type | Individual
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Provider Name | ROBERT DAVID SCHAFFER IDMT
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Gender | Male
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | CMR 402 BOX 775
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City | APO
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State | AE
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Zip | 09180-0775
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Country | US
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Telephone | 208-661-1786
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 N BROADWAY 206
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City | MINOT
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State | ND
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Zip | 58703-1332
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Country | US
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Telephone | 701-723-5133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1003X
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Taxonomy Name | Independent Duty Medical Technicians
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License Number |
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License Number State |
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