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General NPI Number Information
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NPI Number | 1801009436
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Entity Type | Individual
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Provider Name | DAVID C SHONKA JR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/07/2010
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Provider Practice Location Address
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Address Line | 415 RAY C HUNT DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-2980
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Country | US
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Telephone | 434-924-2153
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Fax | 434-243-6522
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Provider Business Mailing Address
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Address Line | PO BOX 9007
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22906-9007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116016420
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 38596
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 38596
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101247630
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License Number State | VA
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