Individual
DR. ELAINE L. SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
306 E VISTULA ST, BRISTOL, IN 46507-9489
(574) 848-4427
(574) 848-4592
Mailing address
306 E VISTULA ST, BRISTOL, IN 46507-9489
(574) 848-4427
(574) 848-4592
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01042902A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109332
ANTHEM BCBS # - BFP
IN
01
—
000000109333
ANTHEM BCBS # - FPA
IN
01
—
000000313699
ANTHEM BCBS # - FMC
IN
01
—
000000536675
ANTHEM BCBS # - OSC
IN
05
—
HPM 39695
—
MI
Enumeration date
07/20/2005
Last updated
03/28/2008
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