NPI age
20 years
Enumerated 2005-09-20
Across 111 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 003791501 | |
| 01 (ID) | 286255 | OREGON HEALTH AND WELFARE |
| 01 (ID) | 000010002020 | BLUE SHIELD OF IDAHO |
| 01 (ID) | DK424 | BLUE CROSS OF IDAHO |
| 01 (ID) | P00209918 | RAILROAD MEDICARE |
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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