NPI age
19 years
Enumerated 2006-08-22
Across 46 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (WA) | 7144785 | |
| 01 | 1370136 | MEDICARE GROUP PTAN |
| 05 (ID) | 8058994 | |
| 01 | 11003291 | MEDICARE PTAN |
| 05 (ID) | 8080036 | |
| 05 (WA) | 8239220 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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