NPI age
20 years
Enumerated 2005-12-30
Across 33 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (MN) | 347197700 | |
| 05 (ID) | 1477530335 | |
| 01 (MN) | 460003751 | RAILROAD |
Part of a multi-provider practice. 223 other active providers share this practice address in NPPES.
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