NPI age
16 years
Enumerated 2010-03-26
Across 1691 active family medicine providers in Idaho.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1369049 | MEDICARE PART B PTAN |
| 01 (ID) | DQ3168 | RAILROAD MEDICARE |
Multi-provider organization. 4 individual providers on file at this primary address.
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