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1417241597
JONATHAN MOORE SHUPE
COEUR D ALENE, ID
NPI
1417241597
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID M12445)
Enumeration Date
2011-06-06
Last Update Date
2020-10-02
Business Address
JONATHAN MOORE SHUPE M.D.
1919 LINCOLN WAY 315
COEUR D ALENE, ID 83814-2527
Phone number: 208-625-6000
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Mailing Address
JONATHAN MOORE SHUPE M.D.
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814-6051
Phone number: 208-625-5085
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