NPI age
16 years
Enumerated 2009-06-25
Across 1691 active family medicine providers in Idaho.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1982832176 |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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