MEDICARE: STEPHEN THOMAS SCHIFFGEN D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	102865-0501	UT

General Provider Information

NPI Number	:	1477556298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN THOMAS SCHIFFGEN D.P.M.

Provider Business Mailing Address
First Line	:	9690 S 1300 E
Second Line	:	# 120
City	:	SANDY
State	:	UT
Zip	:	84094-3721
Country	:	US
Telephone Number	:	801-501-4335
Fax Number	:	801-501-4338

Provider Business Practice Location Address
First Line	:	9690 S 1300 E
Second Line	:	# 120
City	:	SANDY
State	:	UT
Zip	:	84094-3721
Country	:	US
Telephone Number	:	801-501-4335
Fax Number	:	801-501-4338

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/05/2008

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