Individual
DR. SHAUN STUART SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
204 MCCOLLUM DR, SUITE 201, LARAMIE, WY 82070-5103
(307) 742-2131
(307) 742-2134
Mailing address
204 MCCOLLUM DR, SUITE 201, LARAMIE, WY 82070-5103
(307) 742-2131
(307) 742-2134
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
5934A
WY
207W00000X
Ophthalmology Physician
Primary
5934A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118240400
—
WY
01
—
180046305
RAILROAD MEDICARE
—
Enumeration date
08/11/2005
Last updated
12/19/2019
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