Provider Demographics
NPI:1073588109
Name:SHOENTHAL, DONALD R
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:SHOENTHAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HUCH FARM RD
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-3635
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1020 CENTER AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229-1724
Practice Address - Country:US
Practice Address - Phone:412-931-3066
Practice Address - Fax:412-931-2464
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043796E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014057830001Medicaid
PA080076238OtherRR MEDICARE
PA0014057830001Medicaid
PAE55821Medicare UPIN