NPI age
19 years
Enumerated 2006-08-31
Across 3 active plastic surgery providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 76814 | BLUE CROSS OF ID |
| 01 (ID) | 000010024275 | REGENCE BLUE SHIELD OF ID |
| 01 (ID) | 242157007 | RAILROAD MEDICARE |
| 05 (ID) | 003833100 |
Part of a multi-provider practice. 25 other active providers share this practice address in NPPES.
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