Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 50085 | MA |
NPI | 1083803159 |
---|---|
Provider Name | Dr. Ernst John Schaefer |
First Address | Boston, MA 02111-1524 |
Second Address | Boston, MA 02116-5603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2007 |
Last Update Date | 15/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2080478 | (05) | MA |