NPI age
19 years
Enumerated 2006-07-10
Across 68 active podiatrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010152768 | BLUE SHEILD |
| 05 (ID) | 806402300 | |
| 01 (ID) | P-1985 | BLUE CROSS |
| 01 (ID) | 71-0943024 | FEIN |
| 01 (ID) | P00031188 | MEDICARE RAIL ROAD |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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