NPI age
16 years
Enumerated 2009-10-15
Across 55 active clinic/center providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 001758900 | |
| 01 (ID) | 732653 | OPTUM HEALTH |
| 01 (ID) | C9771 | BLUE CROSS OF IDAHO |
Single-site organization. Only one practice location on file.
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