Provider Demographics
NPI:1932168861
Name:SHENENBERGER, DONALD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WILLIAM
Last Name:SHENENBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11844 ROCK LANDING DR STE B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4206
Mailing Address - Country:US
Mailing Address - Phone:757-873-0161
Mailing Address - Fax:757-873-0205
Practice Address - Street 1:11844 ROCK LANDING DR
Practice Address - Street 2:SUITE B
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-0161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101223955207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV4509AMedicare UPIN