MEDICARE: ALAN BRUCE SHAUER MD

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	207RG0100X	Gastroenterology Physician	0101022749	VA

General Provider Information

NPI Number	:	1710912035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN BRUCE SHAUER MD

Provider Business Mailing Address
First Line	:	2616 SHERWOOD HALL LANE
Second Line	:	STE 205
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3154
Country	:	US
Telephone Number	:	703-780-6100
Fax Number	:	703-780-2172

Provider Business Practice Location Address
First Line	:	2616 SHERWOOD HALL LANE
Second Line	:	STE 205
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3154
Country	:	US
Telephone Number	:	703-780-6100
Fax Number	:	703-780-2172

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/13/2007

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