NPI age
20 years
Enumerated 2006-05-25
Across 305 active specialist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010143649 | BLUE SHIELD OF ID |
| 05 (ID) | 805959200 | |
| 01 (ID) | AU571 | BLUE CROSS OF ID |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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