Individual
CHAD R SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3615 STATE ROUTE 28 AND 66, NEW BETHLEHEM, PA 16242-8107
(814) 275-2264
(814) 690-7875
Mailing address
PO BOX 579, KITTANNING, PA 16201-0579
(724) 543-8164
(724) 543-8616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD425669
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013999380001
—
PA
01
—
MD425669
PA STATE LICENSE NUMBER
PA
01
—
SH1746844
PA BLUE SHIELD
PA
Enumeration date
11/01/2006
Last updated
07/08/2007
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