Provider Demographics
NPI:1215168729
Name:SHAFFER, ROBERT RYAN (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RYAN
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 ARMOUR RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3513
Mailing Address - Country:US
Mailing Address - Phone:816-421-0750
Mailing Address - Fax:816-421-0802
Practice Address - Street 1:599 ARMOUR RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3513
Practice Address - Country:US
Practice Address - Phone:816-421-0750
Practice Address - Fax:816-421-0802
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4807207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine