NPI age
19 years
Enumerated 2006-08-29
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 804072000 | |
| 01 (ID) | 010061577 | RAILROAD MEDICARE PTAN |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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