Provider Demographics
NPI:1467444976
Name:SHAFFER, DOROTHY P (MD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:P
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1535
Mailing Address - Country:US
Mailing Address - Phone:513-221-2111
Mailing Address - Fax:513-221-0111
Practice Address - Street 1:3836 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1535
Practice Address - Country:US
Practice Address - Phone:513-221-2111
Practice Address - Fax:513-221-0111
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071837S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4130561Medicare PIN
P00472347Medicare PIN