NPI age
19 years
Enumerated 2007-05-23
Across 1691 active family medicine providers in Idaho.
5 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (OR) | 231902 | |
| 05 (ID) | 806957500 | |
| 01 | NPPU5 | BLUE CROSS-LP |
| 01 | 73437 | BLUE CROSS-REC |
| 01 | 8K818 | BLUE CROSS-GROUP |
| 01 | R108734 | NORIDIAN |
| 01 | 000010147752 | REGENCE-LP |
| 05 (OR) | 278542 | |
| 01 | 000010005775 | REGENCE-REC |
| 05 (ID) | 0036365 | |
| 01 | D80174720 | MEDICARE-RAILROAD |
Multi-provider organization. 5 individual providers on file at this primary address.
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