Provider Demographics
NPI:1306800040
Name:ZETO, SHAWN C (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:C
Last Name:ZETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PEACH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1423
Mailing Address - Country:US
Mailing Address - Phone:814-459-1851
Mailing Address - Fax:814-480-7769
Practice Address - Street 1:240 W 11TH ST STE 301
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1758
Practice Address - Country:US
Practice Address - Phone:814-480-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001965395Medicaid
PA001508797OtherHIGHMARK BCBS
PA001508797OtherHIGHMARK BCBS
PA072185Medicare PIN