Individual
CODY SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1907 W SYCAMORE ST # 200, KOKOMO, IN 46901-5148
(765) 236-8170
Mailing address
1907 W SYCAMORE ST # 200, KOKOMO, IN 46901-5148
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01083629A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11018165A
IN
Other
Enumeration date
06/22/2015
Last updated
08/16/2022
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