Provider Demographics
NPI:1861401531
Name:SCHAFFNER, LIZA GAIL (MD)
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:GAIL
Last Name:SCHAFFNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5808 PERENNIAL LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3585
Mailing Address - Country:US
Mailing Address - Phone:304-677-4845
Mailing Address - Fax:
Practice Address - Street 1:5808 PERENNIAL LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3585
Practice Address - Country:US
Practice Address - Phone:304-677-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-022732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2848940Medicaid
WV3810006505Medicaid
4192636Medicare PIN