Provider Demographics
NPI:1275599896
Name:SHAFFER, MICHAEL C (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2663 AIRPORT RD S
Mailing Address - Street 2:STE D104
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-4875
Mailing Address - Country:US
Mailing Address - Phone:239-793-3200
Mailing Address - Fax:239-793-0756
Practice Address - Street 1:2663 AIRPORT RD S
Practice Address - Street 2:STE D104
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-4875
Practice Address - Country:US
Practice Address - Phone:239-793-3200
Practice Address - Fax:239-793-0756
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55899Medicare UPIN
488604Medicare ID - Type Unspecified