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Individual

SHANNON D. SCHANTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
207 E 12TH ST, EMMETT, ID 83617-3626
(208) 365-1065
(208) 365-1065
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9279

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M6302
ID
207Q00000X
Family Medicine Physician
MD26870
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010005294
REGENCE BLUE CHIELD
ID
05
000269700
ID
01
080167093
RR MEDICARE
ID
01
40667
BLUE CROSS
ID
05
O226808
OR
Enumeration date
01/25/2006
Last updated
01/14/2026
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