Provider Demographics
NPI:1427080233
Name:SHEAFFER, TRACI I (MD)
Entity type:Individual
Prefix:DR
First Name:TRACI
Middle Name:I
Last Name:SHEAFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRACI
Other - Middle Name:E
Other - Last Name:IRWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1540 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6000
Mailing Address - Country:US
Mailing Address - Phone:919-782-3456
Mailing Address - Fax:919-787-7552
Practice Address - Street 1:1520 SUNDAY DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5253
Practice Address - Country:US
Practice Address - Phone:919-782-3456
Practice Address - Fax:919-787-7552
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003-003572084N0400X
NC003572084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134K4Medicaid
NCH90650Medicare UPIN
NC89134K4Medicaid
1427080233Medicare PIN