NPI age
20 years
Enumerated 2005-09-14
Across 260 active surgery providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | S3895 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010138779 | REGENCE BLUE SHIELD OF ID |
| 05 (CA) | XPY200851 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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