Basic Information
Provider Information
NPI: 1699862748
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHLAFF
FirstName: WILLIAM
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 834 CHESTNUT STREET
Address2: SUITE 300
City: PHILADELPHIA
State: PA
PostalCode: 191075127
CountryCode: US
TelephoneNumber: 2159555000
FaxNumber: 2159231089
Practice Location
Address1: 834 CHESTNUT STREET
Address2: SUITE 300
City: PHILADELPHIA
State: PA
PostalCode: 191075127
CountryCode: US
TelephoneNumber: 2159555000
FaxNumber: 2159231089
Other Information
ProviderEnumerationDate: 10/09/2006
LastUpdateDate: 12/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X29858CON Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XMD444362PAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VE0102XMD444362PAY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology

ID Information
IDTypeStateIssuerDescription
0129858705CO MEDICAID


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