NPI age
19 years
Enumerated 2006-07-25
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010158666 | BS PLMC |
| 01 (ID) | 000010160244 | BS DMC |
| 01 (ID) | B5782 | BC DMC |
| 01 (ID) | 76847 | BC PLMC |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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