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General NPI Number Information
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NPI Number | 1801848098
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Entity Type | Individual
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Provider Name | KENNETH E SHAFER MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 721 E MILLTOWN RD
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City | WOOSTER
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State | OH
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Zip | 44691-1255
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Country | US
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Telephone | 330-287-4550
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Fax | 330-287-4691
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Provider Business Mailing Address
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Address Line | 1740 CLEVELAND RD
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City | WOOSTER
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State | OH
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Zip | 44691-2204
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Country | US
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Telephone | 330-287-4500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35076098
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License Number State | OH
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