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Individual

SAMANTHA B SHAFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 536-8969
(814) 536-7180
Mailing address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 536-8969
(814) 536-8969

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052580
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007708200001
PA
Enumeration date
08/01/2006
Last updated
08/24/2011
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