NPI age
19 years
Enumerated 2006-06-18
Across 504 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010003854 | REGENCE BLUE SHIELD |
| 01 (ID) | MD3207 | IDAHO STATE NARC. # |
| 01 (ID) | 4469-3 | BLUE CROSS |
Part of a multi-provider practice. 33 other active providers share this practice address in NPPES.
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