NPI age
19 years
Enumerated 2006-06-11
Across 1691 active family medicine providers in Idaho.
6 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8006347400 | |
| 01 (OR) | R135455 | MEDICARE PART B |
| 01 (ID) | 1369418 | MEDICARE PART B |
Multi-provider organization. 6 individual providers on file at this primary address.
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