NPI age
19 years
Enumerated 2007-04-12
Across 67 active internal medicine providers in Idaho.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 1378037 | CIGNA MEDICARE |
| 01 (ID) | 8F439 | BLUE CROSS |
| 01 (ID) | 000010135203 | REGENCE BLUE SHIELD |
| 01 | CK6464 | RR MEDICARE |
| 05 (ID) | 806207900 |
Multi-provider organization. 20 individual providers on file at this primary address.
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