Healthcare Provider Details

I. General information

NPI: 1538135207
Provider Name (Legal Business Name): HEARTLAND DERMATOLOGY AND SKIN CANCER CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 ELMHURST BLVD
SALINA KS
67401-7406
US

IV. Provider business mailing address

9300 E 29TH ST N STE 310
WICHITA KS
67226-2160
US

V. Phone/Fax

Practice location:
  • Phone: 785-827-2500
  • Fax: 785-827-2515
Mailing address:
  • Phone: 316-612-1833
  • Fax: 316-612-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW P SHAFFER
Title or Position: PRESIDENT
Credential: MD
Phone: 785-577-4448