Individual
DR. SHANE A SERFLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1120 POLARIS PKWY, SUITE 100, COLUMBUS, OH 43240-4042
(614) 847-1120
(614) 847-1205
Mailing address
PO BOX 710725, COLUMBUS, OH 43271-0725
(440) 716-1283
(440) 716-1605
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036118188
IL
207P00000X
Emergency Medicine Physician
34-008486
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209264
ANTHEM
OH
05
—
036118188
—
IL
05
—
0361181882
—
IL
05
—
2568234
—
OH
01
—
36118188
BCBS
IL
01
—
P00415663
RAILROAD MEDICARE
IL
01
—
P00936459
RRMCARE THRU CESIISC (GES)
IL
01
—
P00936461
RRMCARE THRU CESIISC (GES)
IL
Enumeration date
03/17/2006
Last updated
08/17/2011
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