Individual
DOUGLAS EUGENE SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
3451 N BUTLER AVE, FARMINGTON, NM 87401-2357
(505) 566-1915
(505) 566-1918
Mailing address
3451 N BUTLER AVE, FARMINGTON, NM 87401-2357
(505) 566-1915
(505) 566-1918
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20050038NM
NM
Other
Enumeration date
01/26/2007
Last updated
12/12/2007
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