Provider Demographics
NPI:1629070222
Name:SHAY, STEVEN DOUGLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:SHAY
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 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-949-2777
Mailing Address - Fax:717-949-6925
Practice Address - Street 1:2496 STIEGEL PIKE
Practice Address - Street 2:
Practice Address - City:SCHAEFFERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17088-0455
Practice Address - Country:US
Practice Address - Phone:717-949-2777
Practice Address - Fax:717-949-6925
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101060104Medicaid
PAH90262Medicare UPIN
PA071769SL5Medicare ID - Type Unspecified