NPI age
20 years
Enumerated 2005-09-08
Across 252 active pediatrics providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010147395 | BLUE SHIELD |
| 05 (ID) | 806922100 | |
| 01 (ID) | 70896 | BLUE CROSS |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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