Provider Demographics
NPI:1992760862
Name:SCHOEFFLER, ANDRE C (MD)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:C
Last Name:SCHOEFFLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PAT HARALSON DRIVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512
Mailing Address - Country:US
Mailing Address - Phone:706-781-1966
Mailing Address - Fax:706-781-1968
Practice Address - Street 1:150 HOSPITAL CIRCLE
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512
Practice Address - Country:US
Practice Address - Phone:706-781-1966
Practice Address - Fax:706-781-1968
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA39463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891253POtherMCAID
GA39463OtherLICENSE
GA00946393AMedicaid
NC891253POtherMCAID
H14117Medicare UPIN