Individual
ROBERT CREIGHTON SHUMWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, CAQ-PSYCH
Contact information
Practice address
335 E MAIN ST STE 3, SAINT ANTHONY, ID 83445-1546
(208) 356-4900
(208) 624-4030
Mailing address
PO BOX 18, SAINT ANTHONY, ID 83445-0018
(208) 356-4900
(208) 624-4030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1662
ID
Other
Enumeration date
09/18/2018
Last updated
08/25/2025
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