Individual provider · Type 1 NPI

Michael Robert Nieraeth, PA

Surgical Physician Assistant · Boise, ID

NPI number 1487904280 Active

Practice location

8854 W Emerald St Ste 102
Boise, ID 83704

Call (208) 323-4747 Map

Fax (208) 323-4848

Other practice locations

  • 320 Warner Dr, Lewiston, ID 83501-4441 · (208) 743-3523

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA-993 (ID)

Surgical Physician Assistant: Definition to come...

3 other providers at this address

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About NPI 1487904280

Michael Robert Nieraeth, PA's National Provider Identifier is 1487904280, issued on Sep 19, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Boise, ID. The record was last updated on Mar 25, 2019.