MEDICARE: DR. JONATHAN T SCHAAF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	0101253315	VA
2	207Q00000X	Family Medicine Physician	0101253315	VA

General Provider Information

NPI Number	:	1033401294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN T SCHAAF MD

Provider Business Mailing Address
First Line	:	14610 DRAVO PL
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-1564
Country	:	US
Telephone Number	:	804-426-9724
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 WILKES RIDGE PKWY STE 302
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-7460
Country	:	US
Telephone Number	:	804-560-3295
Fax Number	:	888-526-2112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2011
Last Update Date	:	06/25/2023

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