NPI age
20 years
Enumerated 2005-10-21
Across 1263 active physician assistant providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010148622 | BLUE SHIELD |
| 01 (ID) | PACD0 | BLUE CROSS |
| 01 (ID) | PAMR8 | BLUE CROSS |
| 05 (ID) | 807029900 | |
| 01 (ID) | 000010148623 | BLUE SHIELD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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