MEDICARE: JAMES CHRISTOPHER SHAFFER M.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	261QC1500X	Community Health Clinic/Center
2	261Q00000X	Clinic/Center	32355	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	370004646	OTHER	MN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205811312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES CHRISTOPHER SHAFFER M.D.

Provider Business Mailing Address
First Line	:	1700 17TH ST NW
Second Line	:	BUILDING UNIT 417801 #6
City	:	AUSTIN
State	:	MN
Zip	:	55912-6355
Country	:	US
Telephone Number	:	507-440-0767
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 17TH ST NW
Second Line	:	BUILDING UNIT 417801 #6
City	:	AUSTIN
State	:	MN
Zip	:	55912-6355
Country	:	US
Telephone Number	:	507-440-0767
Fax Number	:

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	05/12/2011

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