Healthcare Provider Details

I. General information

NPI: 1114927217
Provider Name (Legal Business Name): DANIEL A SHAYE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 01/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 JAMESTOWN RD STE 103
WILLIAMSBURG VA
23185-3381
US

IV. Provider business mailing address

1307 JAMESTOWN RD STE 103
WILLIAMSBURG VA
23185-3381
US

V. Phone/Fax

Practice location:
  • Phone: 757-229-4161
  • Fax: 757-564-0581
Mailing address:
  • Phone: 757-229-4161
  • Fax: 757-564-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104001672
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: