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General NPI Number Information
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NPI Number | 1740339332
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Entity Type | Individual
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Provider Name | KENNETH ERICH SCHAFERMEYER DO
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 2709 INDUSTRIAL DR STE A
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-0769
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Country | US
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Telephone | 573-635-2141
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Fax | 573-635-5240
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Provider Business Mailing Address
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Address Line | 2709 INDUSTRIAL DR STE A
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-0769
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Country | US
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Telephone | 573-635-2141
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Fax | 573-635-5240
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R8652
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License Number State | MO
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