Provider Demographics
NPI:1104932805
Name:SHAFFER, REBECCA H (MD)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:H
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8630 FENTON STREET
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-588-2525
Mailing Address - Fax:301-588-3447
Practice Address - Street 1:8630 FENTON STREET
Practice Address - Street 2:SUITE700
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-588-2525
Practice Address - Fax:301-588-3447
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0064825207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD753131100Medicaid
MD753131100Medicaid