Provider Demographics
NPI:1639343015
Name:SHAFFER, JAMES ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3399 TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4407
Mailing Address - Country:US
Mailing Address - Phone:717-761-5530
Mailing Address - Fax:717-737-7197
Practice Address - Street 1:3399 TRINDLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4407
Practice Address - Country:US
Practice Address - Phone:717-761-5530
Practice Address - Fax:717-737-7197
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437217207X00000X, 207X00000X
CAA90420207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD437217OtherLICENSE
PA2141792OtherHIGHMARK BLUESHIELD
PA102408791 0001Medicaid
PA50090413OtherCAPITAL BLUECROSS
PA25-1716306OtherINTERGROUP
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA50090413OtherCAPITAL BLUECROSS
PA867633OtherMEDICARE GROUP #
PAG920-0146/KDM4CUOtherCAREFIRST
PA120420411OtherDEPT OF LABOR
PABS9182077OtherDEA #
PA2141792OtherHIGHMARK BLUESHIELD
PA25-1716306OtherGREATWEST HEALTHCARE
PA25-1716306OtherINFORMED
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherHEALTHNET/TRICARE
PA172209LN7Medicare PIN