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General NPI Number Information
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NPI Number | 1134998156
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Entity Type | Organization
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Legal Business Name | INTENTION INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 01/02/2024
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 609 N FRANKLIN ST
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City | WATKINS GLEN
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State | NY
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Zip | 14891-1302
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Country | US
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Telephone | 607-210-6111
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Fax | 607-210-6110
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Provider Business Mailing Address
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Address Line | 609 N FRANKLIN ST
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City | WATKINS GLEN
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State | NY
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Zip | 14891-1302
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Country | US
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Telephone | 607-210-6111
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Fax | 607-210-6110
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANNON SCHAMEL
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Credential | DO
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Telephone | 607-227-4165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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