Provider Demographics
NPI:1962750232
Name:SHAFFER, PAULA L (DAC, L AC)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:L
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:DAC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-0284
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 N MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2133
Practice Address - Country:US
Practice Address - Phone:410-970-0097
Practice Address - Fax:419-791-4827
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01644171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist