Provider Demographics
NPI:1992705206
Name:SHAFER, WILLIAM H JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:SHAFER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5875 BREMO RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-977-8915
Mailing Address - Fax:804-288-1326
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:SUITE 204
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-977-8915
Practice Address - Fax:804-288-1326
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-04-01
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Provider Licenses
StateLicense IDTaxonomies
VA0101032098207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN
VAB07093Medicare UPIN