NPI age
19 years
Enumerated 2006-11-06
Across 1691 active family medicine providers in Idaho.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807622700 | |
| 01 (ID) | 8L568 | BLUE CROSS GROUP # |
Multi-provider organization. 3 individual providers on file at this primary address.
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