Individual
DOUGLAS E. SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3658
(330) 480-3439
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN291861
OH
367500000X
Certified Registered Nurse Anesthetist
RN358639L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000749790
ANTHEM BCBS
OH
05
—
0060361
—
OH
01
—
H064730
MEDICARE PTAN
OH
01
—
P01044986
MEDICARE RAILROAD
OH
01
—
PENDING
MEDICARE PTAN
PA
Enumeration date
01/31/2012
Last updated
10/16/2015
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