NPI age
20 years
Enumerated 2005-06-24
Across 100 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (AZ) | P00958353 | RR MEDICARE |
| 05 (AZ) | 357584 |
Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.
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