Individual
DAVID A SHALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
71 HOSPITAL DRIVE, TOWANDA, PA 18848-9706
(570) 265-6300
(570) 268-2807
Mailing address
259 CHURCH ST, APT 32, KINGSTON, PA 18704-5331
(570) 287-8524
(570) 268-8524
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD030260E
PA
207RR0500X
Rheumatology Physician
Primary
MD030260E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014906210004
—
PA
Enumeration date
07/31/2012
Last updated
11/06/2012
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