| NPI | 1073079463 |
|---|---|
| Doing Business As | PRIMARY HEALTH MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | TRISHA NAUMAN Credentialing Manager 208-955-6522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |