Provider Demographics
NPI:1942590872
Name:SHAEFER, ALEXIS BASHINSKI (MD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:BASHINSKI
Last Name:SHAEFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:PAULINE
Other - Last Name:BASHINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1210 ROY RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1812
Mailing Address - Country:US
Mailing Address - Phone:706-860-6515
Mailing Address - Fax:706-860-1225
Practice Address - Street 1:1210 ROY RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1812
Practice Address - Country:US
Practice Address - Phone:706-860-6515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0753642084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology