NPI age
14 years
Enumerated 2011-07-11
Across 12 active orthopaedic surgery providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | 13885664 | CAQH |
| 05 (NV) | 1053609073 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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