Provider Demographics
NPI:1134469992
Name:SHAFRAN, MICHAEL ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:SHAFRAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PHEASANT RUN STE 123
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3413
Mailing Address - Country:US
Mailing Address - Phone:215-702-8600
Mailing Address - Fax:215-633-3480
Practice Address - Street 1:104 PHEASANT RUN STE 123
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3413
Practice Address - Country:US
Practice Address - Phone:215-702-8600
Practice Address - Fax:215-633-3480
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0181292086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS018129OtherMEDICAL LICENSE
PAOS018129OtherMEDICAL LICENSE