NPI age
19 years
Enumerated 2006-08-21
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | S5258 | BLUE CROSS |
| 01 (ID) | J3698 | BLUE CROSS |
| 01 (ID) | 000010000238 | BLUE SHIELD |
| 01 (ID) | 000010152070 | BLUE SHIELD |
| 05 (ID) | 004313500 |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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