NPI age
19 years
Enumerated 2006-09-28
Across 1 active nuclear medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M-9696 | ID MEDICAL LICENSE |
| 01 (WA) | MD00047026 | WA MEDICAL LICENSE |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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