National Provider Identifier Database

LUCY E MODAHL, MD, PHD – NPI #1902868730
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Contact Information

LUCY E MODAHL, MD, PHD
601 FRONT AVENUE
SUITE #502
COEUR D'ALENE, ID  83814
Phone: 208-415-0524
Fax: 208-763-3644
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X

* Indicates primary specialty

NPI Profile & details for LUCY E MODAHL

NPI Number 1902868730
Credentials MD, PHD
Entity Individual
Enumeration date 04/05/2006
Last updated 05/26/2009 - About 17 years ago
Sole proprietor1 Yes
Identifiers
  • ID License #: M9541
  • KY Medicaid: 7100025960
  • PA Medicaid: 101968783
  • PA Medicaid: 1019687930001
  • VA Medicaid: 1902868730
  • KY Other: 000000548186 ANTHEM
  • KY Other: 50017558 PASSPORT
  • KY Other: 3425955000 PASSPORT ADVANTAGE
  • KY Other: 91725 SIHO
  • PA Other: 2950085 MEDICAL ASSISTANCE NY
  • PA Other: 1019687830001 MEDICAL ASSISTANCE PA
  • VA Other: 3810010476 MEDICAID WV
  • VA Other: P00403958 MEDICARE RAILROAD
Hospital affiliation n/a

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.

Reviews for LUCY E MODAHL, MD, PHD

There are currently no reviews for LUCY E MODAHL, MD, PHD

NPIdb - Home
v2.201