Provider Demographics
NPI:1700814290
Name:SHOBER, MICHELE M (DO)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:SHOBER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-2178
Mailing Address - Country:US
Mailing Address - Phone:724-658-5597
Mailing Address - Fax:724-658-8364
Practice Address - Street 1:708 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-2178
Practice Address - Country:US
Practice Address - Phone:724-658-5597
Practice Address - Fax:724-658-8364
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007168L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015016540001Medicaid
PA626978OtherHIGHMARK
PA626978OtherKEYSTONE
PA626978Medicare ID - Type Unspecified
PA0015016540001Medicaid