Provider Demographics
NPI:1508026352
Name:SHAUBERGER, JAMES ROSS (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROSS
Last Name:SHAUBERGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:MEADOWVIEW
Mailing Address - State:VA
Mailing Address - Zip Code:24361-0297
Mailing Address - Country:US
Mailing Address - Phone:276-496-4492
Mailing Address - Fax:
Practice Address - Street 1:13168 MEADOWVIEW SQUARE
Practice Address - Street 2:
Practice Address - City:MEADOWVIEW
Practice Address - State:VA
Practice Address - Zip Code:24361
Practice Address - Country:US
Practice Address - Phone:276-944-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202581207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP01539083OtherRAILROAD MEDICARE
TNQ016533Medicaid
VA1508026352Medicaid
VA1508026352Medicaid