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Contact Information

NATHAN L ROACH, MD
190 E BANNOCK ST
BOISE, ID83712-6241
 Phone: 208-381-1615
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospice and Palliative Medicine

207RH0002X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for NATHAN L ROACH · (Male)

NPI Number 1396206181
Status Active
Credentials MD
Entity Individual
Enumeration date 03/26/2019
Last updated 07/03/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M-17232
  • IN License # 11020323A
Hospital affiliation(s) Not Available
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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