NPI age
18 years
Enumerated 2007-06-14
Across 67 active podiatrist providers in Idaho.
15 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | DD9805 | RAILROAD MEDICARE |
| 01 (ID) | 000010034464 | BLUE SHIELD |
| 01 (ID) | P9364 | BLUE CROSS |
| 05 (ID) | 806125200 |
Multi-provider organization. 15 individual providers on file at this primary address.
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