NPI age
19 years
Enumerated 2006-10-19
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002462200 | |
| 01 (ID) | 756083066 | MEDICARE RAILROAD |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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