Provider Demographics
NPI:1689624645
Name:SHLAER, STEPHEN MICHEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MICHEAL
Last Name:SHLAER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1348 WALTON WAY
Mailing Address - Street 2:STE 6700
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-5104
Mailing Address - Country:US
Mailing Address - Phone:706-722-4245
Mailing Address - Fax:706-722-6652
Practice Address - Street 1:1348 WALTON WAY
Practice Address - Street 2:STE 6700
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-5104
Practice Address - Country:US
Practice Address - Phone:706-722-4245
Practice Address - Fax:706-722-6652
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA16487207RH0003X
SC32180207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00151951DMedicaid
SC908726Medicaid
SC908726Medicaid
GAD30815Medicare UPIN