MEDICARE: DR. PAUL J SHLAFER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	MN1963	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11986	OTHER	MN	COLE MANAGED VISION CARE
2	84414SH	OTHER	MN	BCBS
3	23746	OTHER	MN	AMERICA'S PPO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MN1963	OTHER	MN	EYEMED VISION CARE
6	SH1426016	OTHER	MN	CLARITY VISION
7	22-20252	OTHER	MN	MEDICA /UNITED HEALTHCARE

General Provider Information

NPI Number	:	1154327757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL J SHLAFER O.D.

Provider Business Mailing Address
First Line	:	3333 HAZELTON RD
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-4204
Country	:	US
Telephone Number	:	952-926-5300
Fax Number	:	952-926-2729

Provider Business Practice Location Address
First Line	:	3333 HAZELTON RD
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-4204
Country	:	US
Telephone Number	:	952-926-5300
Fax Number	:	952-926-2729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	04/05/2010

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