Organization · Type 2 NPI

Idaho Pediatric Gastroenterology PA

Specialist · Boise, ID

NPI number 1780871467 Active

Practice location

100 E Idaho St, Suite 316
Boise, ID 83712-6223

Call (208) 381-7310 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XM7673 (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.

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About NPI 1780871467

Idaho Pediatric Gastroenterology PA's National Provider Identifier is 1780871467, issued on Sep 26, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Boise, ID. The record was last updated on Sep 26, 2007.