person
Dr. Wayne Marcus Mortensen, MD
Diagnostic Radiology Physician in Boise, Idaho
NPI 1780878314

Wayne Marcus Mortensen is a Diagnostic Radiology Physician based in Corvallis, ID and is specialized in Diagnostic Radiology. Wayne Marcus Mortensen practices in Boise, ID and has the professional credentials of MD. The NPI Number for Wayne Marcus Mortensen is 1780878314 and holds a License No. 0116019824 (Idaho).

The current practice location address for Wayne Marcus Mortensen is 190 E Bannock St, Boise, ID and can be reached out via phone at 208-381-2094 and via fax at 208-381-1791.

Location: 190 E Bannock St, Boise, ID, 97339-1108
person
Provider Profile Details
NPI Number
1780878314
Provider Name
Wayne Marcus Mortensen
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
190 E Bannock St, Boise, ID, 97339-1108
Phone Number
208-381-2094
Fax Number
208-381-1791
Provider Enumeration Date
08/27/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
190 E Bannock St
City
State
Zip
83712-6241
Phone Number
208-381-2094
Fax Number
208-381-1791
person
Provider Business Mailing Address Details
Address
190 E Bannock St
City
State
Zip
83712-6241
Phone Number
208-381-2094
Fax Number
208-381-1791
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
7152301-1205 (Utah)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
0116019824 (Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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