Provider Demographics
NPI:1083694335
Name:SCHAFER, HEINZ-PETER (M D)
Entity type:Individual
Prefix:DR
First Name:HEINZ-PETER
Middle Name:
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 WREN ST
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-1529
Mailing Address - Country:US
Mailing Address - Phone:803-259-5762
Mailing Address - Fax:803-259-3250
Practice Address - Street 1:13975 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:SC
Practice Address - Zip Code:29853-5835
Practice Address - Country:US
Practice Address - Phone:803-266-0060
Practice Address - Fax:803-266-0042
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC241622083P0901X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC241624Medicaid
SCSC0795OtherMEDICARE