NPI age
20 years
Enumerated 2006-04-05
Across 248 active radiology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (PA) | 101968783 | |
| 01 (PA) | 1019687830001 | MEDICAL ASSISTANCE PA |
| 01 (KY) | 50017558 | PASSPORT |
| 01 (KY) | 000000548186 | ANTHEM |
| 05 (PA) | 1019687930001 | |
| 01 (VA) | P00403958 | MEDICARE RAILROAD |
| 01 (KY) | 3425955000 | PASSPORT ADVANTAGE |
| 05 (VA) | 1902868730 | |
| 01 (VA) | 3810010476 | MEDICAID WV |
| 01 (PA) | 2950085 | MEDICAL ASSISTANCE NY |
| 05 (KY) | 7100025960 | |
| 01 (KY) | 91725 | SIHO |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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