Individual provider · Type 1 NPI

Blake D. Niederhauser, MD

Diagnostic Radiology Physician · Boise, ID

NPI number 1578726683 Active

Practice location

190 E Bannock St
Boise, ID 83712-6241

Call (208) 381-2094 Map

Fax (208) 381-1791

Mailing address

7211 Wellington Dr Ste 101
Knoxville, TN 37919-5968

Other practice locations

  • 7211 Wellington Dr Ste 101, Knoxville, TN 37919-5968 · (865) 588-8005

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202X104451 (MN)
Diagnostic Radiology Physician 2085R0202X52314 (MN)
Diagnostic Radiology Physician 2085R0202X24807 (TN)
Diagnostic Radiology Physician 2085R0202XM-12384 (ID)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1578726683

Blake D. Niederhauser, MD's National Provider Identifier is 1578726683, issued on Jul 8, 2008. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Boise, ID. The record was last updated on Sep 11, 2026.