NPI age
17 years
Enumerated 2009-01-19
Across 22 active emergency medicine providers in Idaho.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M4363 | LICNESE NUMBER |
| 01 (ID) | 8N801 | BLUE CROSS |
Multi-provider organization. 20 individual providers on file at this primary address.
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