NPI age
20 years
Enumerated 2005-12-09
Across 68 active podiatrist providers in Idaho.
6 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | I0007985456 | AETNA |
| 01 (ID) | P00224830 | RR MEDICARE PIN |
| 01 (ID) | 000010149213 | BLUE SHIELD |
| 01 (ID) | P2165 | BLUE CROSS - PROVIDER # |
| 01 (ID) | P9293 | BLUE CROSS - CLINIC # |
Multi-provider organization. 6 individual providers on file at this primary address.
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