NPI age
20 years
Enumerated 2005-12-16
Across 78 active urology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010000609 | REGENCE |
| 01 (ID) | 20006147 | NORIDIAN-MEDICARE |
| 05 (ID) | 003782100 | |
| 01 (ID) | 4117-8 | BLUECROSS |
Part of a multi-provider practice. 56 other active providers share this practice address in NPPES.
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