NPI age
19 years
Enumerated 2006-06-08
Across 46 active internal medicine providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (MT) | 000099678 | BCBS PIN |
| 01 (WY) | 121300800 | MDCD PIN |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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