NPI age
19 years
Enumerated 2006-06-13
Across 22 active internal medicine providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (MI) | 1000914 | MCLAREN HEALTH PLAN-MEDICAID |
| 05 (MI) | 104833738 | |
| 01 (MI) | 1103300241 | BCBS/BCN |
| 01 (MI) | 0M76680001 | MEDICARE ADVANTAGE |
| 01 (MI) | 200000001034 | PHP FAMILYCARE |
| 01 (MI) | 900002953 | RAILROAD MEDICARE |
| 01 (MI) | 1000914 | MCLAREN HEALTH ADVANTAGE |
| 01 (MI) | 1103300241 | HEALTHPLUS OF MICHIGAN |
| 01 (MI) | 200000001034 | PHP |
| 05 (MI) | 3454811 | |
| 01 (MI) | 1000914 | MCLAREN HEALTH PLAN-COMMERCIAL |
| 05 (MI) | 3454830 | |
| 01 (MI) | 4062823 | AETNA |
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
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