NPI age
19 years
Enumerated 2007-03-08
Across 93 active clinic/center providers in Idaho.
17 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010025421 | BLUESHIELD |
| 01 (ID) | HW173 | BLUE CROSS |
| 05 (ID) | 0028319 |
Multi-provider organization. 17 individual providers on file at this primary address.
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