NPI age
19 years
Enumerated 2006-06-07
Across 504 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P00141643 | RR MEDICARE |
| 05 (ID) | 806701300 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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