NPI age
20 years
Enumerated 2006-05-04
Across 20 active pain medicine providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 003692900 | |
| 01 (ID) | 000010158339 | BLUE SHIELD OF IDAHO |
| 01 (ID) | 76755 | BLUE CROSS OF IDAHO |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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