NPI age
19 years
Enumerated 2007-04-06
Across 326 active clinic/center providers in Idaho.
10 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806530400 | |
| 01 (ID) | 8J059 | BLUE CROSS GROUP NUMBER |
| 05 (ID) | 806867300 | |
| 01 (ID) | 000010151377 | BLUE SHIELD GROUP # |
Multi-provider organization. 10 individual providers on file at this primary address.
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