NPI age
20 years
Enumerated 2006-04-28
Across 336 active emergency medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (OR) | 287943 | |
| 05 (ID) | 004159100 | |
| 01 | 930020408 | RR MEDICARE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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