NPI age
12 years
Enumerated 2013-08-15
Across 9 active family medicine providers in Idaho.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M-7882 | IDAHO MEDICAL LICENSE |
Multi-provider organization. 4 individual providers on file at this primary address.
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