Shaffer, Blake Richard

Shaffer, Blake Richard is an individual health care provider with primary practice located at 307 Boatner Rd Ste 114 , Eglin Afb FL 32542-1302. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Shaffer, Blake Richard can be contacted via phone (850) 883-8600.

Contact Information

Primary practice address
307 Boatner Rd Ste 114 Eglin Afb FL 32542-1302
Phone: (850) 883-8600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MT208977 Pennsylvania
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 0101261224 Virginia

Profile Details

NPI number 1235510140
LBN Legal business name Shaffer, Blake Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2015
Last updated Jun 5th, 2020 - about 4 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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