Provider Demographics
NPI:1972864049
Name:SHAEFFER, ZANE AARON (MD)
Entity Type:Individual
Prefix:
First Name:ZANE
Middle Name:AARON
Last Name:SHAEFFER
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 1:1420 E YALE AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-1615
Mailing Address - Country:US
Mailing Address - Phone:801-824-5305
Mailing Address - Fax:
Practice Address - Street 1:1400 N I-35, SUITE C3.314
Practice Address - Street 2:UT SOUTHWESTERN AUSTIN-EMERGENCY MEDICINE PROGRAM
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043000207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine