NPI age
20 years
Enumerated 2005-12-01
Across 260 active surgery providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1548244718 | REGENCE BLUESHIELD |
| 01 (ID) | 77796 | BC/ID |
| 05 (ID) | 1548244718 | |
| 05 (WA) | 2001383 | |
| 01 (WA) | 0244969 | LABOR & INDUSTRIES |
| 01 (ID) | P00717410 | RR MEDICARE |
Part of a multi-provider practice. 56 other active providers share this practice address in NPPES.
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