NPI age
20 years
Enumerated 2005-10-21
Across 504 active internal medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | S0883 | BLUE CROSS |
| 05 (ID) | 002365800 | |
| 01 (ID) | 110057530 | RAILROAD MEDICARE |
| 01 (ID) | 000010006056 | BLUE SHIELD |
Part of a multi-provider practice. 47 other active providers share this practice address in NPPES.
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