NPI age
19 years
Enumerated 2007-01-09
Across 1 active clinic/center providers in Idaho.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 00257 | BLUE CROSS |
| 05 (ID) | 002292400 | |
| 01 (ID) | 000010004925 | REGENCE BLUE SHIELD |
Multi-provider organization. 20 individual providers on file at this primary address.
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