NPI age
19 years
Enumerated 2007-01-03
Across 22 active emergency medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010003680 | REGENCE BS ID |
| 01 (ID) | B1717 | BLUE CROSS ID |
| 05 (WA) | 8144412 |
Part of a multi-provider practice. 58 other active providers share this practice address in NPPES.
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