Provider Demographics
NPI:1851401228
Name:SHEFFNER, PAUL W (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:SHEFFNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11477 OLDE CABIN ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7137
Mailing Address - Country:US
Mailing Address - Phone:314-567-5000
Mailing Address - Fax:314-567-3110
Practice Address - Street 1:12255 DEPAUL DRIVE
Practice Address - Street 2:SUITE 500
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2510
Practice Address - Country:US
Practice Address - Phone:314-567-5000
Practice Address - Fax:314-567-3110
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR80072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201038031Medicaid
MO116683OtherHEALTHLINK
MO260049227OtherRR MEDICARE
MO116683OtherHEALTHLINK
MOA09849Medicare UPIN