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NPI Code Detail

MEDICARE: NATHAN SHAFER OD

MEDICARE:   NATHAN  SHAFER  OD
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
1152W00000XOptometrist18004657AIN

General Provider Information

NPI Number : 1336070150
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN SHAFER OD
Provider Business Mailing Address
First Line : 67 E GARNER RD STE 800
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-7609
Country : US
Telephone Number : 317-852-5000
Fax Number : 317-852-5009
Provider Business Practice Location Address
First Line : 67 E GARNER RD STE 800
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-7609
Country : US
Telephone Number : 317-852-5000
Fax Number : 317-852-5009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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