NPI age
19 years
Enumerated 2007-02-26
Across 37 active clinic/center providers in Idaho.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8074373 | |
| 01 | HW157 | BLUE CROSS OF IDAHO |
| 01 | 000010019677 | BLUE SHIELD |
Multi-provider organization. 3 individual providers on file at this primary address.
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