Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2020-03342 | NC |
N | 208600000X | Surgeon | 2020-03342 | NC |
N | 208200000X | Surgeon | 4301102816 | MI |
N | 208600000X | Surgeon | 4301102816 | MI |
Y | 2086X0206X | Surgical Oncologist | 2020-03342 | NC |
NPI | 1265878680 |
---|---|
Provider Name | Dr. Kristina May Shaffer |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28215-7072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2013 |
Last Update Date | 16/08/2021 |