Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 200001269 | NC |
N | 208600000X | Surgeon | 200001269 | NC |
N | 208200000X | Surgeon | MD427602 | PA |
N | 208600000X | Surgeon | MD427602 | PA |
Y | 2086S0120X | Pediatric Surgery | 0101237914 | VA |
NPI | 1245227628 |
---|---|
Provider Name | Dr. Shawn David Safford |
First Address | Hershey, PA 17033-2360 |
Second Address | Hershey, PA 17033-0858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 01/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101933652 | (05) | PA |
1245227628 | (05) | NC |
Q0126M | (05) | SC |