Northridge Internal Medicine, Pllc

NPI 1033394713 - Internal Medicine - 207R00000X

NPI Details
NPI 1033394713
Enumeration Date 12/31/2007
Last Updated 02/11/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name RODNEY RODNEY
Position MEMBER
Phone (208) 656-8456
Fax (208) 656-8444
Practice Location
36 PROFESSIONAL PLZ
STE-102
REXBURG ID, 83440-2049, US
Phone (208) 656-8456
Fax (208) 656-8444
Business Location
36 PROFESSIONAL PLZ
STE-102
REXBURG ID, 83440-2049, US
Phone (208) 656-8456
Fax (208) 656-8444
Toxanomy
Taxonomy Code 207R00000X
License State Idaho
License Number O0359
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According to our database, Northridge Internal Medicine, Pllc NPI is 1033394713, taxonomy code is 207R00000X and license number is O0359, license state is located at Idaho. Northridge Internal Medicine, Pllc physically located at 36 Professional Plz, Rexburg ID, 83440-2049. NPI Number 1033115704 has the healthcare provider type.

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1033394713 NPI number is provided on an as is basis without warranty of any kind. 1033394713 is maintained by the National Plan & Provider Enumeration System. The contents of Northridge Internal Medicine, Pllc are for informational purposes only.