NPI age
20 years
Enumerated 2006-05-23
Across 252 active pediatrics providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1003861626 | REGENCE BLUE SHIELD |
| 05 (ID) | 1003861626 | |
| 01 (ID) | 1003861626 | BLUE CROSS OF IDAHO |
| 05 (WA) | 1003861626 |
Part of a multi-provider practice. 56 other active providers share this practice address in NPPES.
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