Lakeside Pediatric & Adolescent Medicine, Pllc

NPI 1003975087 - Pediatrics - 2080A0000X

NPI Details
NPI 1003975087
Enumeration Date 12/06/2006
Last Updated 07/12/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DIANA R DIANA
Position OFFICE MANAGER
Phone (208) 292-5437
Fax (208) 292-5441
Practice Location
980 W IRONWOOD DR
STE 302
COEUR D'ALENE ID, 83814-2601, US
Phone (208) 292-5437
Fax (208) 292-5441
Business Location
980 W IRONWOOD DR
STE 302
COEUR D'ALENE ID, 83814-2601, US
Phone (208) 292-5437
Fax (208) 292-5441
Toxanomy
Taxonomy Code 2080A0000X
License State
License Number
Remove 1003975087 NPI Number
 

According to our database, Lakeside Pediatric & Adolescent Medicine, Pllc NPI is 1003975087, taxonomy code is 2080A0000X Lakeside Pediatric & Adolescent Medicine, Pllc physically located at 980 W Ironwood Dr, Coeur D'alene ID, 83814-2601. NPI Number 1033115704 has the healthcare provider type.

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1003975087 NPI number is provided on an as is basis without warranty of any kind. 1003975087 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeside Pediatric & Adolescent Medicine, Pllc are for informational purposes only.