Organization
COLLEGE FIELDS MRI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY D SHAFFER (OWNER/OPERATOR)
(724) 658-9700
Entity
Organization
Contact information
Practice address
130 ENCLAVE DR, NEW CASTLE, PA 16105-3208
(724) 658-9700
(724) 658-9666
Mailing address
130 ENCLAVE DR, NEW CASTLE, PA 16105-3208
(724) 658-9700
(724) 658-9666
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019247120001
—
PA
01
—
1398419
HIGHMARKBCBS
PA
Enumeration date
04/24/2006
Last updated
03/26/2008
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