NPI age
19 years
Enumerated 2007-02-01
Across 67 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1102834 | CIGNA MEDICARE |
| 01 (ID) | 45898 | BLUE CROSS |
| 05 (ID) | 806139200 | |
| 01 (ID) | P00063543 | RR MEDICARE |
| 01 (ID) | 000010034564 | BLUE SHIELD |
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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