Individual
CHARLES W SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1115 E 20TH ST, SIOUX FALLS, SD 57105-1013
(605) 575-1616
(605) 367-7157
Mailing address
1115 E 20TH ST, SIOUX FALLS, SD 57105-1013
(605) 575-1616
(605) 367-7157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1917
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5605100
—
SD
05
—
951814200
—
MN
Enumeration date
02/14/2006
Last updated
04/02/2020
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