MEDICARE: DR. GREGORY SCHAEFER D.O.

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	208600000X	Surgery Physician	54012	WV
2	208600000X	Surgery Physician	2009-01141	NC
3	2086S0102X	Surgical Critical Care Physician	2709	WV
4	2086S0102X	Surgical Critical Care Physician	2009-01141	NC
5	2086S0127X	Trauma Surgery Physician	2009-01141	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528180346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY SCHAEFER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 897
Second Line	:	UNIVERSITY HEALTH ASSOCIATES
City	:	MORGANTOWN
State	:	WV
Zip	:	26507-0897
Country	:	US
Telephone Number	:	304-285-7101
Fax Number	:	304-293-6963

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER DRIVE
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26506-0897
Country	:	US
Telephone Number	:	304-598-4800
Fax Number	:	304-293-6963

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	04/15/2022

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Directions to “ DR. GREGORY SCHAEFER D.O.” Practice Location

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