NPI age
19 years
Enumerated 2007-03-07
Across 93 active clinic/center providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 000010018973 | BLUE SHIELD |
| 01 | HW280 | BLUE CROSS OF IDAHO |
| 05 (ID) | 8073420 |
Multi-provider organization. 1 individual provider on file at this primary address.
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