Provider Demographics
NPI:1487067070
Name:PHYSICAL MEDICINE OF THE CAROLINA'S
Entity type:Organization
Organization Name:PHYSICAL MEDICINE OF THE CAROLINA'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-547-4343
Mailing Address - Street 1:1698 HIGHWAY 160 W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8032
Mailing Address - Country:US
Mailing Address - Phone:803-547-4343
Mailing Address - Fax:803-547-3914
Practice Address - Street 1:40 WESTGATE PKWY
Practice Address - Street 2:#5
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-3867
Practice Address - Country:US
Practice Address - Phone:803-547-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty