NPI age
12 years
Enumerated 2014-04-09
Across 100 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 8966461 | MEDICARE PIN |
| 05 (WA) | 1689093395 |
Part of a multi-provider practice. 37 other active providers share this practice address in NPPES.
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