Provider Demographics
NPI:1720051089
Name:SCHAFFER, STEPHEN B (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3841 PIPER ST
Mailing Address - Street 2:SUITE T230
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4624
Mailing Address - Country:US
Mailing Address - Phone:907-279-8800
Mailing Address - Fax:907-279-8810
Practice Address - Street 1:3841 PIPER ST
Practice Address - Street 2:SUITE T230
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4624
Practice Address - Country:US
Practice Address - Phone:907-279-8800
Practice Address - Fax:907-279-8810
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO41238207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO25527321Medicaid
CO498888Medicare ID - Type Unspecified
CO25527321Medicaid