NPI age
7 years
Enumerated 2018-06-19
Across 1691 active family medicine providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | MD61081789 | DEPARTMENT OF HEALTH |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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