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Individual

DR. MARK WILLIAM SHAFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
513B GREAT OAKS DR, MONROE, GA 30655-8211
(770) 267-9391
(770) 207-7196
Mailing address
513B GREAT OAKS DR, MONROE, GA 30655-8211
(770) 267-9391
(770) 207-7196

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000585
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00401497B
GA
05
00401497C
GA
Enumeration date
07/05/2005
Last updated
09/20/2010
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