NPI age
20 years
Enumerated 2005-07-07
Across 67 active podiatrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 804309300 | |
| 01 (ID) | P1571 | BLUE CROSS |
| 01 (ID) | 341488 | DMBA |
| 01 (ID) | 480034721 | MEDICARE RAILROAD |
| 01 (ID) | 000010015672 | BLUE SHIELD |
| 01 (ID) | 461973001 | DMERC |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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