NPI age
19 years
Enumerated 2006-12-12
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010151310 | REGENCE |
| 05 (ID) | 003594300 | |
| 01 (ID) | PIN B5688 GR 8M925 | BLUE CROSS |
Single-site organization. Only one practice location on file.
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