NPI age
19 years
Enumerated 2006-07-05
Across 28 active psychiatry & neurology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010002546 | REGENCE BLUE SHIELD OF ID |
| 01 (ID) | DX621 | BLUE CROSS OF IDAHO |
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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