Provider Demographics
NPI:1487799953
Name:SCHAFER, SCOTT DAVID (PT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVID
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3857
Mailing Address - Country:US
Mailing Address - Phone:724-746-0447
Mailing Address - Fax:412-257-0317
Practice Address - Street 1:3249 WASHINGTON PIKE STE 1102
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1461
Practice Address - Country:US
Practice Address - Phone:412-257-0314
Practice Address - Fax:412-257-0317
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015498225100000X
PADAPT000078225100000X
FLPT16730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA266039OtherHEALTHAMERICA PROV NUMBER
PA6431559OtherCIGNA PROVIDER NUMBER
PA7733459OtherAETNA PPO EPO
PA1086009OtherAETNA HMO POS
PA096444Medicare ID - Type UnspecifiedGROUP NUMBER
PA058132UTWMedicare ID - Type UnspecifiedPROVIDER NUMBER