GUILLERMO MODAD

MOSCOW, ID
NPI1588982888
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208M00000X Hospitalist
(Licence: ID  M-12525)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
208000000X Pediatrics
(Licence: ID  m-12525)
Enumeration Date2010-05-11
Last Update Date2024-07-19
Business Address
GUILLERMO MODAD M.D.
700 S MAIN ST
MOSCOW, ID 83843-3046
Phone number: 208-882-4511
Mailing Address
GUILLERMO MODAD M.D.
PO BOX 8007
MOSCOW, ID 83843-0507
Phone number: 208-883-2224