Individual
SHANNON SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
247 S BURNETT RD STE 210, SPRINGFIELD, OH 45505-2663
(937) 328-8850
(937) 328-8860
Mailing address
247 S BURNETT RD STE 210, SPRINGFIELD, OH 45505-2663
(937) 328-8850
(937) 328-8860
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003863
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0092432
—
OH
Enumeration date
10/02/2013
Last updated
08/19/2019
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