NPI age
20 years
Enumerated 2005-10-24
Across 252 active pediatrics providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010005678 | BLUE SHIELD |
| 01 (ID) | 33266 | BLUE CROSS |
| 05 (ID) | 805527400 | |
| 01 (ID) | 46151 | BLUE CROSS |
| 01 (ID) | 80635330 | HEALTHY CONNECTIONS |
| 01 (ID) | 000010005679 | BLUE SHIELD |
| 01 (ID) | 33191 | BLUE CROSS |
| 01 (ID) | 000010135658 | BLUE SHIELD |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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