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NPI Code Detail

MEDICARE: HEATHER SHAFFER MD PA

MEDICARE: HEATHER SHAFFER MD PA
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
1207Q00000XFamily Medicine PhysicianME84800FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
281116OTHERFLBCBS OF FLORIDA

General Provider Information

NPI Number : 1790877512
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEATHER SHAFFER MD PA
Provider Business Mailing Address
First Line : PO BOX 1280
Second Line :
City : PANAMA CITY
State : FL
Zip : 32402-1280
Country : US
Telephone Number : 850-785-3464
Fax Number : 850-785-2791
Provider Business Practice Location Address
First Line : 1937 HARRISON AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4543
Country : US
Telephone Number : 850-785-3464
Fax Number : 850-785-2791
Authorized Official
Title or Position : PRESIDENT
Name : DR. HEATHER S ZAWAHRY
Credential : M.D.
Telephone Number : 850-785-3464
Provider Enumeration Date : 09/29/2006
Last Update Date : 03/21/2013

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