NPI age
18 years
Enumerated 2007-12-04
Across 75 active general practice providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | DA558 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010003687 | BLUE SHIELD OF IDAHO |
Single-site organization. Only one practice location on file.
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