NPI age
19 years
Enumerated 2007-03-01
Across 326 active clinic/center providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8073803 | |
| 01 | HW264 | BLUE CROSS OF IDAHO |
| 01 | 000010018440 | BLUE SHIELD |
Single-site organization. Only one practice location on file.
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