Basic Information
Provider Information
NPI: 1063828689
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHAFER
FirstName: MATTHEW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 988102 NEBRASKA MEDICAL CENTER
Address2:  
City: OMAHA
State: NE
PostalCode: 681988102
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 987400 NEBRASKA MEDICAL CTR
Address2:  
City: OMAHA
State: NE
PostalCode: 681981150
CountryCode: US
TelephoneNumber: 4025596637
FaxNumber: 4025598333
Other Information
ProviderEnumerationDate: 07/02/2014
LastUpdateDate: 05/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X7308NEN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X30031NEY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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