Healthcare Provider Details

I. General information

NPI: 1851521173
Provider Name (Legal Business Name): HARVEY SHAFFER DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 3RD AVE
LONGMONT CO
80501-5602
US

IV. Provider business mailing address

20 3RD AVE
LONGMONT CO
80501-5602
US

V. Phone/Fax

Practice location:
  • Phone: 303-651-3039
  • Fax: 303-651-7691
Mailing address:
  • Phone: 303-651-3039
  • Fax: 303-651-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number2633
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: