Healthcare Provider Details

I. General information

NPI: 1457471989
Provider Name (Legal Business Name): SHAFER VISION CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 E GARNER RD STE 800
BROWNSBURG IN
46112-7609
US

IV. Provider business mailing address

67 E GARNER RD STE 800
BROWNSBURG IN
46112-7609
US

V. Phone/Fax

Practice location:
  • Phone: 317-852-5000
  • Fax: 317-852-5009
Mailing address:
  • Phone: 317-852-5000
  • Fax: 317-852-5009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MELISSA B SHAFER
Title or Position: PRESIDENT
Credential: OD, FAAO
Phone: 317-852-5000