Basic Information
| Provider Information | |||||||||
| NPI: | 1033183983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHOENBERGER | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 S MAIN STREET | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | COOPERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180362028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102821170 | ||||||||
| FaxNumber: | 6102820256 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 S MAIN STREET | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | COOPERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180362028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102821170 | ||||||||
| FaxNumber: | 6102820256 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2006 | ||||||||
| LastUpdateDate: | 05/20/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD044386E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.