NPI age
16 years
Enumerated 2009-06-12
Across 1691 active family medicine providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1730316043 | |
| 05 (WI) | 1730316043 | |
| 05 (MT) | 1730316043 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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