NPI age
19 years
Enumerated 2007-01-09
Across 75 active general practice providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010155351 | BLUE SHIELD |
| 01 (ID) | S6008 | BLUE CROSS |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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