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1588629406
RUSSELL M KOCEMBA
BOISE, ID
NPI
1588629406
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID M7077)
Enumeration Date
2006-04-20
Last Update Date
2014-01-23
Business Address
-- RUSSELL M KOCEMBA MD
3301 N SAWGRASS WAY
BOISE, ID 83704-4493
Phone number: 208-375-0862
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Mailing Address
-- RUSSELL M KOCEMBA MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-375-0862
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