Shafer, Ronald Morton

Shafer, Ronald Morton is an sole proprietor health care provider with primary practice located at 3461 Bridlewood Lane , Terre Haute IN 47802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Shafer, Ronald Morton can be contacted via phone (812) 243-1590.

Contact Information

Primary practice address
3461 Bridlewood Lane Terre Haute IN 47802
Phone: (812) 243-1590
Fax: (812) 234-6614
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01062324A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01048560 Indiana

Profile Details

NPI number 1053354050
LBN Legal business name Shafer, Ronald Morton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Jan 4th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053354050 NPPES
Indiana Other 000000481852 BCBS
Indiana MEDICAID 200828520A BCBS

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