NPI age
19 years
Enumerated 2007-01-25
Across 305 active specialist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 88799 | BLUE CROSS GROUP # |
| 05 (ID) | 002705200 | |
| 01 (ID) | 000010006189 | REGENCE GROUP # |
| 05 (WA) | 7125115 |
Single-site organization. Only one practice location on file.
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