Individual
DONALD SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
41100 FOX RUN, NOVI, MI 48377-4804
(248) 668-8650
(248) 668-8651
Mailing address
5525 RESEARCH PARK DRIVE, 4TH FLOOR, BALTIMORE, MD 21228-4664
(248) 668-8650
(248) 668-8651
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002860
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158217680
BCBS MI
—
01
—
83-05251
EVERCARE
—
01
—
DS002860
BCBS MI
—
Enumeration date
07/03/2006
Last updated
05/06/2015
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