NPI age
20 years
Enumerated 2005-06-10
Across 25 active thoracic surgery (cardiothoracic vascular surgery) providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (IN) | 000001021963 | ANTHEM PROVIDER NUMBER UNDER TIN 35-2030653 |
| 05 (IN) | 201352320 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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