Individual
GENE W SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5501 OLD YORK RD, WILLOWCREST 4TH FLOOR, PHILADELPHIA, PA 19141-3018
(215) 456-7900
(215) 456-5948
Mailing address
5501 OLD YORK RD, WILLOWCREST 4TH FLOOR, PHILADELPHIA, PA 19141-3018
(215) 456-7900
(215) 324-2426
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD059569L
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD059569L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018092920001
—
PA
Enumeration date
10/13/2005
Last updated
07/13/2015
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