Provider Demographics
NPI:1073201356
Name:SHAFER VISION INSTITUTE
Entity Type:Organization
Organization Name:SHAFER VISION INSTITUTE
Other - Org Name:SHAFER VISION INSTITUTE, INCORPORATED
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-210-2169
Mailing Address - Street 1:633 W GERMANTOWN PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1032
Mailing Address - Country:US
Mailing Address - Phone:215-654-2020
Mailing Address - Fax:215-278-4048
Practice Address - Street 1:633 W GERMANTOWN PIKE STE 100
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1032
Practice Address - Country:US
Practice Address - Phone:215-654-2020
Practice Address - Fax:215-278-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty