Individual provider · Type 1 NPI

Blake Richard Shaffer, MD

Student in an Organized Health Care Education/Training Program · Eglin Afb, FL

NPI number 1235510140 Active

Practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Call (850) 883-8600 Map

Specialties and licenses

TaxonomyCodeLicense
Internal Medicine Physician 207R00000XMT208977 (PA)
Student in an Organized Health Care Education/Training Program Primary 390200000X0101261224 (VA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1235510140

Blake Richard Shaffer, MD's National Provider Identifier is 1235510140, issued on Jun 16, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Eglin Afb, FL. The record was last updated on Jun 5, 2020.