Individual
TIMOTHY JASON SHAEFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
BUILDING 5, CHARLESTOWN NAVY YARD, USS CONSTITUTION, CHARLESTOWN, MA 02129-1797
(617) 799-8194
(617) 242-2308
Mailing address
34 WILDWOOD LN, WALTHAM, MA 02451-1859
(617) 799-8194
(617) 242-2308
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/04/2006
Last updated
12/27/2010
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