NPI age
20 years
Enumerated 2005-09-20
Across 111 active internal medicine providers in Idaho.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010005904 | BLUE SHIELD OF IDAHO |
| 05 (ID) | 002733600 | |
| 01 (ID) | 55293 | BLUE CROSS OF IDAHO |
| 01 (ID) | 100001868 | RAILROAD MEDICARE |
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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