NPI age
19 years
Enumerated 2006-09-27
Across 1691 active family medicine providers in Idaho.
7 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1112918 | MEDICARE |
| 05 (ID) | 002606200 |
Multi-provider organization. 7 individual providers on file at this primary address.
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