Provider Demographics
NPI:1154327757
Name:SHLAFER, PAUL J (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:SHLAFER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:J
Other - Last Name:SCHLAEFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3333 HAZELTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4204
Mailing Address - Country:US
Mailing Address - Phone:952-926-5300
Mailing Address - Fax:952-926-2729
Practice Address - Street 1:3333 HAZELTON RD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4204
Practice Address - Country:US
Practice Address - Phone:952-926-5300
Practice Address - Fax:952-926-2729
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN1963152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11986OtherCOLE MANAGED VISION CARE
MN84414SHOtherBCBS
MN23746OtherAMERICA'S PPO
MN540825300Medicaid
MNMN1963OtherEYEMED VISION CARE
MNSH1426016OtherCLARITY VISION
MN22-20252OtherMEDICA /UNITED HEALTHCARE
MN410001657Medicare ID - Type Unspecified
MN23746OtherAMERICA'S PPO
MNMN1963OtherEYEMED VISION CARE