Individual
SIMON-PETER SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
64 HENDERSON CV RD, INDUSTRY, ME 04938-4579
(207) 778-5542
(207) 778-5580
Mailing address
64 HENDERSON CV RD, INDUSTRY, ME 04938-4579
(207) 778-5542
(207) 778-5580
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.003662
IL
363AM0700X
Medical Physician Assistant
PA203
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ME2191
—
ME
Enumeration date
12/04/2007
Last updated
01/08/2010
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