NPI age
20 years
Enumerated 2006-04-07
Across 248 active radiology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (KY) | 3427930000 | PASSPORT ADVANTAGE |
| 01 (KY) | 91826 | SIHO |
| 01 (KY) | 000000548191 | ANTHEM |
| 05 (VA) | 010348447 | |
| 01 (NY) | 176241 | NYS LICENSE # |
| 05 (KY) | 7100025670 | |
| 01 (KY) | 50017675 | PASSPORT |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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