NPI age
20 years
Enumerated 2005-09-02
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010000246 | BLUE SHIELD PROVIDER NUMB |
| 01 (ID) | 080179524 | RR MEDICARE PROVIDER NUMB |
| 01 (ID) | DI726 | BLUE CROSS PROVIDER NUMBE |
| 05 (ID) | 804222200 |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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