| NPI | 1215398672 |
|---|---|
| Doing Business As | BINGHAM HEALTHCARE SPECIALTY CLINIC - 17TH ST |
| Doing Business As | BINGHAM MEMORIAL FAMILY MEDICINE (4) |
| Entity Type | Organization |
| Authorized Contact | JACOB ERICKSON CEO 208-785-3801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2019-12-17 |