Provider Demographics
NPI:1144222985
Name:SPEIER SCHAFER, CARRIE LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:LYNN
Last Name:SPEIER SCHAFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CARA
Other - Middle Name:L
Other - Last Name:SPEIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:31410 NORTHWESTERN HWY STE A
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2563
Mailing Address - Country:US
Mailing Address - Phone:248-476-7650
Mailing Address - Fax:248-702-6188
Practice Address - Street 1:31410 NORTHWESTERN HWY STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2563
Practice Address - Country:US
Practice Address - Phone:248-476-7650
Practice Address - Fax:248-702-6188
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012509207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4338737Medicaid
MION24960Medicare ID - Type Unspecified
MIH32489Medicare UPIN