Provider Demographics
NPI:1255319042
Name:SHOBER, DAVID R (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:SHOBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2520 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1644
Mailing Address - Country:US
Mailing Address - Phone:724-658-7550
Mailing Address - Fax:724-658-7551
Practice Address - Street 1:2520 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1644
Practice Address - Country:US
Practice Address - Phone:724-658-7550
Practice Address - Fax:724-658-7551
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007137L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01267364Medicaid
PA608518Medicare ID - Type UnspecifiedMEDICARE
PA01267364Medicaid