| NPI | 1790960961 |
|---|---|
| Doing Business As | IDAHO DIABETES & ENDOCRINE ASSOCIATES, PA |
| Entity Type | Organization |
| Authorized Contact | THEODORE S ROOSEVELT President 208-389-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2022-05-18 |