Provider Demographics
NPI:1114927217
Name:SHAYE, DANIEL A (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:SHAYE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 JAMESTOWN RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3381
Mailing Address - Country:US
Mailing Address - Phone:757-229-4161
Mailing Address - Fax:757-564-0581
Practice Address - Street 1:1307 JAMESTOWN RD STE 103
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3381
Practice Address - Country:US
Practice Address - Phone:757-229-4161
Practice Address - Fax:757-564-0581
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001672111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA15529P62OtherMEDICARE INDIVIDUAL PTAN
VAC05162OtherMEDICARE GROUP PTAN
VA15529P62OtherMEDICARE INDIVIDUAL PTAN
U62594Medicare UPIN