NPI age
20 years
Enumerated 2005-10-21
Across 504 active internal medicine providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806314500 | |
| 01 (ID) | 48025 | BLUE CROSS |
| 01 (ID) | 000010138343 | BLUE SHIELD |
| 01 (ID) | 110238082 | RAILROAD MEDICARE |
| 01 | 806395800 | HEALTHY CONNECTIONS |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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