Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Alan Daugherty

Individual provider Urology Physician · NPI 1154902096

Shane Alan Daugherty is an Urology in Meadville, Pennsylvania. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2021, 5 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Pennsylvania.

Years since qualifying
5
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
PA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

765 Liberty St Ste 207A
Meadville, PA 16335-2568
Phone: (814) 373-2156
Fax: (814) 373-2159
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4160 John R St Ste 1017, Detroit, MI 48201-2017 — (313) 745-4123

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence OS026090 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1154902096
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 20, 2021
Last updated in NPPESJune 30, 2026
Certification dateJune 30, 2026
Mailing address1034 Grove St, Meadville, PA 16335-2945

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

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