MEDICARE: MICHAEL D SHAFFER DO

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	207Q00000X	Family Medicine Physician	L6627	TX
2	207Q00000X	Family Medicine Physician	34-009337	OH
3	207QS0010X	Sports Medicine (Family Medicine) Physician	L6627	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	P01527361	OTHER	TX	RAILROAD MEDICARE

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
2	8M0733	OTHER	TX	HMO BLUE
3	90049	OTHER	NM	PRESBYTERIAN COMMERCIAL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	8FE660	OTHER	TX	BCBS
12	8M6326	OTHER	TX	BCBS
13	A030	OTHER	NM	TRIWEST
14	139450101	OTHER	TX	FIRSTCARE COMMERCIAL
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	8JE232	OTHER	TX	BCBSTX - WCCA

General Provider Information

NPI Number	:	1417949983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D SHAFFER DO

Provider Business Mailing Address
First Line	:	575 HILL COUNTRY DR
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-6024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1331 BANDERA HWY STE 4
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-9535
Country	:	US
Telephone Number	:	830-258-7762
Fax Number	:

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	05/27/2026

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Directions to “ MICHAEL D SHAFFER DO” Practice Location

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