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General NPI Number Information
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NPI Number | 1932249224
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Entity Type | Individual
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Provider Name | MICHAEL RICHARD SHAFFNER MD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 1001 JOHNSON FERRY RD NE DEPT OF EMERGENCY MEDICINE
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City | ATLANTA
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State | GA
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Zip | 30342-1605
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Country | US
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Telephone | 678-344-1960
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 MANHASSET FARM RD
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City | ATLANTA
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State | GA
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Zip | 30338-3436
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Country | US
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Telephone | 770-394-3684
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 040230
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License Number State | GA
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