Provider Demographics
NPI:1396324240
Name:SHAFFER, NICHOLAS STAVROS (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:STAVROS
Last Name:SHAFFER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF PSYCHIATRY RESIDENCY PROGRAM
Mailing Address - Street 2:7703 FLOYD CURL DRIVE MC 7792
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3900
Mailing Address - Country:US
Mailing Address - Phone:210-567-1601
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY RESIDENCY PROGRAM
Practice Address - Street 2:7703 FLOYD CURL DRIVE MC 7792
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3900
Practice Address - Country:US
Practice Address - Phone:210-567-1601
Practice Address - Fax:210-567-3483
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program