Basic Information
| Provider Information | |||||||||
| NPI: | 1295843225 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHAEFER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7450 FRANCE AVE S | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554354787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528328100 | ||||||||
| FaxNumber: | 9528328148 | ||||||||
| Practice Location | |||||||||
| Address1: | 7450 FRANCE AVE S | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554354787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528328100 | ||||||||
| FaxNumber: | 9528328148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 11/17/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 44604 | MN | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 1294189 | 01 | MN | FIRST HEALTH/COVENTRY HLT | OTHER | 7737477 | 01 | MN | AETNA INS | OTHER | HP35710 | 01 | MN | HEALTHPARTNERS | OTHER | 0801673 | 01 | MN | MEDICA | OTHER | 180001325 | 01 | MN | MEDICARE | OTHER | 960561031417 | 01 | MN | PREFERRED ONE | OTHER | 1031417 | 01 | MN | PREFERRED ONE | OTHER | 1295843225 | 01 | MN | AMERICA'S PPO | OTHER | 142777 | 01 | MN | UCARE MN | OTHER | 1652146 | 01 | MN | AMERICA'S PPO | OTHER | 0800890 | 01 | MN | MEDICA | OTHER | 080482700 | 05 | MN | MEDICAID | 64G33SC | 01 | MN | BCBS OF MN | OTHER | 852K6SC | 01 | MN | BCBS | OTHER |