NPI age
20 years
Enumerated 2005-07-01
Across 56 active otolaryngology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (MT) | 0083130 | |
| 05 (WA) | 8409252 | |
| 01 | 000010006074 | REGENCE BLUE SHIELD OF ID |
| 01 | 58065 | BLUE CROSS OF IDAHO |
Part of a multi-provider practice. 65 other active providers share this practice address in NPPES.
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