Provider Demographics
NPI:1710005970
Name:SHATS, DANIEL (MD, MBA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SHATS
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MOUNT WOOD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:
Practice Address - Street 1:46898 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8764
Practice Address - Country:US
Practice Address - Phone:740-449-2196
Practice Address - Fax:740-449-2198
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA-85003207R00000X, 390200000X
PAMD440935207R00000X
OH35098773207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV99999Medicaid
OH99999Medicaid
WV99999Medicare PIN
OH99999Medicaid