Provider Demographics
NPI:1215344593
Name:SHAFFER, NATHAN RICHARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:RICHARD
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 N CANNON AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4919
Mailing Address - Country:US
Mailing Address - Phone:301-797-8400
Mailing Address - Fax:301-739-3674
Practice Address - Street 1:34 N CANNON AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4919
Practice Address - Country:US
Practice Address - Phone:301-797-8400
Practice Address - Fax:301-739-3674
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist