Individual provider · Type 1 NPI
Carl Ray Dettwiler, MD
Specialist · Lewiston, ID
NPI number
1285623819
Active
Practice location
2517 17th Sreet, Suite B
Lewiston, ID 83501-0001
Fax (208) 743-3369
Mailing address
2517 17th St, Suite B
Lewiston, ID 83501-6311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | M5110 (ID) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Other specialist providers in Lewiston
About NPI 1285623819
Carl Ray Dettwiler, MD's National Provider Identifier is 1285623819, issued on Oct 17, 2005. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Lewiston, ID. The record was last updated on Dec 16, 2025.