NPI age
19 years
Enumerated 2006-06-03
Across 1691 active family medicine providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 080105158 | RR MEDICARE |
| 05 (ID) | 003957900 |
Multi-provider organization. 1 individual provider on file at this primary address.
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