NPI age
20 years
Enumerated 2006-05-19
Across 248 active radiology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010155405 | REGENCE |
| 05 (ID) | 807411600 | |
| 01 (ID) | 8M816 | BLUE CROSS |
Single-site organization. Only one practice location on file.
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