NPI age
20 years
Enumerated 2006-01-25
Across 19 active obstetrics & gynecology providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010003851 | REGENCE BLUE SHIELD OF ID |
| 05 (ID) | 003885000 | |
| 01 (ID) | 33092 | BLUE CROSS OF ID |
| 05 (OR) | 121074 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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