NPI age
11 years
Enumerated 2014-05-27
Across 1691 active family medicine providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | 1164834040 | NPI |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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