NPI age
19 years
Enumerated 2006-09-26
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807909700 | |
| 05 (WY) | 123432300 | |
| 05 (ID) | 807875400 |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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