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Pediatric Surgery Of Idaho
Pediatric Surgery Physician in Boise, Idaho
NPI 1609997261

Pediatric Surgery Of Idaho is a Pediatric Surgery Physician based in Boise, ID and is specialized in Pediatric Surgery. Pediatric Surgery Of Idaho practices in Boise, ID. The NPI Number for Pediatric Surgery Of Idaho is 1609997261 and holds a License No. (Idaho).

The current practice location address for Pediatric Surgery Of Idaho is 100 E Idaho St Ste 300, Boise, ID and can be reached out via phone at 208-345-5400 and via fax at 208-345-5454.

Location: 100 E Idaho St Ste 300, Boise, ID, 83712-6269
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Provider Profile Details
NPI Number
1609997261
Provider Name
Pediatric Surgery Of Idaho
Credential
Provider Entity Type
Organization
Address
100 E Idaho St Ste 300, Boise, ID, 83712-6269
Phone Number
208-345-5400
Fax Number
208-345-5454
Provider Enumeration Date
04/02/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8C683 01 ID BLUE CROSS GROUP #
00010018063 01 ID BLUE SHIELD GROUP #
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Provider Business Practice Location Address Details
Address
100 E Idaho St Ste 300
City
State
Zip
83712-6269
Phone Number
208-345-5400
Fax Number
208-345-5454
person
Provider Business Mailing Address Details
Address
100 E Idaho St Ste 300
City
State
Zip
83712-6269
Phone Number
208-345-5400
Fax Number
208-345-5454
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Pediatric Surgery
Taxonomy
License No.
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Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
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