Individual
MARK R SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
90 ADELINE RD, NEWTON, MA 02459-2705
(401) 273-7100
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
158271
MA
Other
Enumeration date
05/01/2006
Last updated
05/04/2017
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