NPI age
19 years
Enumerated 2007-02-09
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 080186325 | RRMCR |
| 05 (ID) | 003701700 |
Solo or small practice. No other active providers share this practice address in NPPES.
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