Basic Information
| Provider Information | |||||||||
| NPI: | 1316960149 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEAFFER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | DEAN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1209 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287440569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282131500 | ||||||||
| FaxNumber: | 8286516570 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | HAZLETON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182016835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702704455 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 01/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 8371 | ND | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2008-01979 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | OS007163L | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.