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Spencer D Greendyke Md Llc
Medical Specialty Clinic/Center in Coeur D'alene, Idaho
NPI 1558468439

Spencer D Greendyke Md Llc is a Medical Specialty Clinic/Center based in Coeur D'alene, ID and is specialized in Medical Specialty. Spencer D Greendyke Md Llc practices in Coeur D'alene, ID. The NPI Number for Spencer D Greendyke Md Llc is 1558468439 and holds a License No. M9110 (Idaho).

The current practice location address for Spencer D Greendyke Md Llc is 3318 N Grand Mill Ln, Coeur D'alene, ID and can be reached out via phone at 208-277-1060 and via fax at 208-277-1065.

Location: 3318 N Grand Mill Ln, Coeur D'alene, ID, 83814
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1558468439
Provider Name
Spencer D Greendyke Md Llc
Credential
Provider Entity Type
Organization
Address
3318 N Grand Mill Ln, Coeur D'alene, ID, 83814
Phone Number
208-277-1060
Fax Number
208-277-1065
Provider Enumeration Date
09/20/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
3318 N Grand Mill Ln
City
Coeur D'alene
State
Idaho
Zip
83814
Phone Number
208-277-1060
Fax Number
208-277-1065
person
Provider Business Mailing Address Details
Address
3318 N Grand Mill Ln
City
Coeur D'alene
State
Idaho
Zip
83814
Phone Number
208-277-1060
Fax Number
208-277-1065
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
M9110 (Idaho)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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