| NPI | 1174741441 |
|---|---|
| Doing Business As | BEAR LAKE INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | LAURIE BINGHAM Contract Management 208-847-4327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M7743) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2012-12-17 |