Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 041412314 | VA |
N | 1223P0106X | Oral and Maxillofacial Pathology | DS0000010158 | TN |
N | 1223P0106X | Oral and Maxillofacial Pathology | DSO23468L | PA |
NPI | 1043211899 |
---|---|
Provider Name | Dr. Duane Robert Schafer |
First Address | Greenville, TX 75404-8887 |
Second Address | Richmond, VA 23298-5064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 31/01/2019 |