Shantz, Ian M

Shantz, Ian M is an individual health care provider with primary practice located at 2401 Brandermill Blvd Suite 250, Gambrills MD 21054-1690. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shantz, Ian M can be contacted via phone (410) 721-1507.

Contact Information

Primary practice address
2401 Brandermill Blvd Suite 250 Gambrills MD 21054-1690
Phone: (410) 721-1507
Fax: (410) 721-1510
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0036203 Maryland

Profile Details

NPI number 1083607410
LBN Legal business name Shantz, Ian M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Nov 29th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1083607410 NPPES
Other 4668884 AETNA PPO
Other 9961 AETNA PPO
Other 0002 AETNA PPO
Other 2133458 AETNA PPO
MEDICAID 278331200 AETNA PPO
Other 609636400 AETNA PPO
Other 2110345 AETNA PPO
Other 52030309 AETNA PPO
Other 218331200 AETNA PPO

Popular Providers