NPI age
20 years
Enumerated 2005-09-23
Across 46 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | 11003341 | MEDICARE PTAN |
| 05 (ID) | 8078889 | |
| 05 (ID) | 8080036 | |
| 05 (WA) | 8497588 | |
| 05 (WA) | 7144785 | |
| 01 | 1370136 | MEDICARE GROUP PTAN |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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