Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 16025 | CO |
NPI | 1023192812 |
---|---|
Provider Name | Larry A Schafer |
First Address | Denver, CO 80211-5326 |
Second Address | Wheat Ridge, CO 80033-6018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 01/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01160258 | (05) | CO |
D22971 | (02) |