NPI age
20 years
Enumerated 2006-03-30
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 11029901 | MEDICARE PTAN |
| 05 (ID) | 805202000 | |
| 01 | P00031256 | RAILROAD MEDICARE |
| 01 | 1102998 | CIGNA MEDICARE |
| 01 | 1102990 | CIGNA MEDICARE |
Part of a multi-provider practice. 161 other active providers share this practice address in NPPES.
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