NPI age
20 years
Enumerated 2005-09-21
Across 305 active specialist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002626200 | |
| 01 (ID) | 200004982 | RAILROAD MEDICARE |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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