NPI age
19 years
Enumerated 2006-11-29
Across 102 active dermatology providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 43414 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010021230 | BLUE SHIELD OF IDAHO |
| 05 (ID) | 002586300 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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