NPI age
20 years
Enumerated 2006-05-03
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806641400 | |
| 01 (ID) | 000010143145 | REGENCE BLUE SHIELD |
| 01 (ID) | 313054 | ALTIUS |
| 01 (ID) | S5593 | BLUE CROSS OLD |
Part of a multi-provider practice. 35 other active providers share this practice address in NPPES.
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