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1164470613
ROGER L STAGG
BOISE, ID
NPI
1164470613
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: ID M3453)
Enumeration Date
2006-05-05
Last Update Date
2012-09-18
Business Address
-- ROGER L STAGG MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-4100
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Mailing Address
-- ROGER L STAGG MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-4100
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