NPI age
20 years
Enumerated 2005-06-20
Across 68 active podiatrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807150700 | |
| 01 (OR) | P00251554 | RAILROAD MEDICARE |
| 01 (OR) | 861141948 | TAX ID |
| 05 (OR) | 023111 | |
| 01 (OR) | 4540570001 | MEDICARE DMERC |
| 01 (ID) | P00251554 | RAILROAD MEDICARE |
Solo or small practice. No other active providers share this practice address in NPPES.
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