Healthcare Provider Details

I. General information

NPI: 1912843228
Provider Name (Legal Business Name): SHAUNAK DIGAMBAR DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SAM PERRY BLVD STE 201
FREDERICKSBURG VA
22401-4491
US

IV. Provider business mailing address

13 PROSPECT HILL BLVD
CHESTER SPRINGS PA
19425-3694
US

V. Phone/Fax

Practice location:
  • Phone: 540-741-9200
  • Fax:
Mailing address:
  • Phone: 610-246-8598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: