Individual
MARK EDWARD SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 US HIGHWAY 321 BYP N, WINNSBORO, SC 29180-7100
(803) 635-6099
(803) 635-6343
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31836
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318365
—
SC
Enumeration date
07/02/2009
Last updated
06/25/2021
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