Individual
DR. CANDACE F SHANKS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1008 11TH ST, DE WITT, IA 52742-1210
(563) 659-9137
(563) 659-9869
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4190
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26904
IA
207Q00000X
Family Medicine Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06423
WELLMARK HEALTH PLAN
IA
05
—
2042713
—
IA
01
—
IA0104
JOHN DEERE PIN #
—
Enumeration date
03/14/2006
Last updated
07/09/2007
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