IndividualActive
Blake Shaffer, MD
NPI 1235510140 · Student in an Organized Health Care Education/Training Program · Eglin Afb, FL
Provider details
- NPI number
- 1235510140
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MT208977 (PA)
Specialties & taxonomies
- Student in an Organized Health Care Education/Training ProgramPrimary390200000XLicense 0101261224 (VA)
Student, Health Care
Allopathic & Osteopathic Physicians
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone: (850) 883-8600
Street-level locationGet directions
Mailing address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Registry dates
- Enumerated
- 2015-06-16
- Last updated
- 2020-06-05
- Certified
- 2020-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.