NPI age
19 years
Enumerated 2006-07-18
Across 69 active neurological surgery providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (OR) | 288294 | OMAP |
| 01 (ID) | 000010029707 | REGENCE BLUE SHIELD |
| 01 | 128615500 | US DEPARTMENT OF LABOR |
| 01 (ID) | 000010163125 | REGENCE BLUE SHIELD TALUS |
| 05 (ID) | 1699793661 | |
| 01 (ID) | 76747 | BLUE CROSS OF IDAHO |
| 01 (ID) | 0214271 | WA DEPT OF LABOR |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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