Individual
DR. CHARLES STEPHEN SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 7TH ST W, PARK RAPIDS, MN 56470-1872
(218) 699-3121
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60110
MN
208M00000X
Hospitalist Physician
60110
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60110
STATE LICENSE
MN
Enumeration date
06/17/2010
Last updated
12/11/2023
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