NPI age
12 years
Enumerated 2013-08-08
Across 68 active podiatrist providers in Idaho.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 1351091 | MEDICARE PTAN |
| 01 | 4792930001 | MEDIARE DME |
| 01 | P00031188 | RAILROAD MEDICARE |
| 05 (ID) | 806402300 | |
| 01 | P1985 | BLUE CROSS OF IDAHO |
Multi-provider organization. 2 individual providers on file at this primary address.
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