NPI age
19 years
Enumerated 2006-08-28
Across 28 active psychiatry & neurology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010004266 | BLUE SHIELD |
| 05 (ID) | 000911100 | |
| 01 (ID) | 56812 | BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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