Idaho Skin Surgery Center, Pc

NPI 1295908127 - Dermatology - 207ND0101X

NPI Details
NPI 1295908127
Enumeration Date 04/11/2008
Last Updated 12/12/2014
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name JARED JARED
Position PRESIDENT
Phone (208) 433-1114
Fax (208) 433-1115
Practice Location
1906 S VISTA AVE
BOISE ID, 83705-3453, US
Phone (208) 433-1114
Fax (208) 433-1115
Business Location
1906 S VISTA AVE
BOISE ID, 83705-3453, US
Phone (208) 433-1114
Fax (208) 433-1115
Toxanomy
Taxonomy Code 207ND0101X
License State Idaho
License Number M-10116
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According to our database, Idaho Skin Surgery Center, Pc NPI is 1295908127, taxonomy code is 207ND0101X and license number is M-10116, license state is located at Idaho. Idaho Skin Surgery Center, Pc physically located at 1906 S Vista Ave, Boise ID, 83705-3453. NPI Number 1033115704 has the healthcare provider type.

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1295908127 NPI number is provided on an as is basis without warranty of any kind. 1295908127 is maintained by the National Plan & Provider Enumeration System. The contents of Idaho Skin Surgery Center, Pc are for informational purposes only.