NPI age
1 years
Enumerated 2024-08-19
Across 7 active surgery providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M13235 | IDAHO BOARD OF MEDICINE |
Multi-provider organization. 1 individual provider on file at this primary address.
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