NPI age
20 years
Enumerated 2006-05-12
Across 1263 active physician assistant providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002790900 | |
| 01 (ID) | 970003235 | RAILROAD MEDICARE |
| 01 (ID) | 1185830001 | MEDICARE DMERC |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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