Provider Demographics
NPI:1538621511
Name:SCHMIT, SHANNON MARIE (MD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:SCHMIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 SOUTHWESTERN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1236
Mailing Address - Country:US
Mailing Address - Phone:716-712-0490
Mailing Address - Fax:
Practice Address - Street 1:3075 SOUTHWESTERN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1236
Practice Address - Country:US
Practice Address - Phone:716-712-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316269208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics