Provider Demographics
NPI:1962557702
Name:SCHLAFF, MARY JUDITH
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JUDITH
Last Name:SCHLAFF
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 W. 13 MILE ROAD, 400 FSC
Mailing Address - Street 2:PHYSICIAN CONTRACT SERVICES
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6769
Mailing Address - Country:US
Mailing Address - Phone:248-423-2410
Mailing Address - Fax:248-423-2576
Practice Address - Street 1:44201 DEQUINDRE RD STE EC
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1117
Practice Address - Country:US
Practice Address - Phone:248-964-5111
Practice Address - Fax:248-964-5068
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045874207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine