Individual
JASON SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 BROADWAY, SOMERVILLE, MA 02145-2935
(401) 737-7010
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 737-7010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1018961
MA
207Q00000X
Family Medicine Physician
1043898273
RI
207Q00000X
Family Medicine Physician
LP05391
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2021
Last updated
11/04/2024
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