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Contact Information

SAMUAL BASS, MD
300 E JEFFERSON
STE 101
BOISE, ID83712
 Phone: 208-336-4141
 Fax: 208-336-4035
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SAMUAL BASS · (Male)

NPI Number 1841234747
Status Active
Credentials MD
Entity Individual
Enumeration date 06/15/2006
Last updated 09/11/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M9570
  • IL License # M9570
Hospital affiliation(s)
  • ST LUKE'S ELMORE MEDICAL CENTER - (Critical Access)
    895 NORTH 6TH EAST
    MOUNTAIN HOME, ID 83647
  • ST LUKE'S MCCALL - (Critical Access)
    1000 STATE STREET
    MC CALL, ID 83638
  • ST LUKES REGIONAL MEDICAL CENTER - (Acute Care)
    190 EAST BANNOCK STREET
    BOISE, ID 83712
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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