NPI age
20 years
Enumerated 2006-05-02
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P00434702 | RR MEDICARE |
| 05 (ID) | 002498800 | |
| 01 (ID) | P01032140 | MCRR |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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