Idaho Diabetes And Endocrine Associates, Pa in Boise - Specialist
Idaho Diabetes And Endocrine Associates, Pa - NPI 1790960961
Idaho Diabetes And Endocrine Associates, Pa is a Specialist in Boise, Idaho. Idaho Diabetes And Endocrine Associates, Pa practices all healthcare services and medical treatments related to Specialist. The NPI Number for Idaho Diabetes And Endocrine Associates, Pa is 1790960961. The last update date is 2022-05-18.
Idaho Diabetes And Endocrine Associates, Pa's current location address is 13909 W. Wainwright Drive, Boise, Idaho. You can contact this provider via phone number 2083892213 and fax number 2083894659. The mailing address for Idaho Diabetes And Endocrine Associates, Pa is 13909 W. Wainwright Drive, Boise, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Idaho Diabetes And Endocrine Associates, Pa |
|---|---|
| Address | 13909 W. Wainwright Drive, Boise, Idaho |
| Phone Number | 2083892213 |
| Fax Number | 2083894659 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Roosevelt S Theodore |
| Credentials | MD, PHD, J |
| Telephone Number | 2083892213 |
NPI Number Detail
| NPI Number | 1790960961 |
|---|---|
| Provider Enumeration Date | 2008-01-07 |
| Last Updated Date | 2022-05-18 |
Provider Mailing Address Detail
| Address | 13909 W. Wainwright Drive |
|---|---|
| City | Boise |
| State | Idaho (ID) |
| Post Code | 837131969 |
| Phone Number | 2083892213 |
| Fax Number | 2083894659 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
|
Definition: 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. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10035381 | ID | REGENCE BLUE SHIELD OF ID | |
| 2712100 | ID | -- | |
| 77021 | ID | BLUE CROSS OF IDAHO |
Post Comment/ Review Below
What is the Idaho Diabetes And Endocrine Associates, Pa's 1790960961?
The Idaho Diabetes And Endocrine Associates, Pa's NPI (National Provider Identifier) Number is 1790960961. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Idaho Diabetes And Endocrine Associates, Pa is physically located?
The Idaho Diabetes And Endocrine Associates, Pa is situated at the following address: 13909 W. Wainwright Drive, Boise, ID 837131969.
What is the Idaho Diabetes And Endocrine Associates, Pa's area of specialization and corresponding taxonomy classification?
The Idaho Diabetes And Endocrine Associates, Pa's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
When did the Idaho Diabetes And Endocrine Associates, Pa receive its 1790960961?
The Idaho Diabetes And Endocrine Associates, Pa was issued its 1790960961 on 2008-01-07, which is the date when the organization was assigned this unique identifier.
When was the information regarding Idaho Diabetes And Endocrine Associates, Pa, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Idaho Diabetes And Endocrine Associates, Pa, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2022-05-18.
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