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Contact Information

PEDIATRIC CARDIOLOGY OF IDAHO
900 N LIBERTY ST STE 206
BOISE, ID83704-8729
 Phone: 208-453-9962
 Fax: 208-453-9963
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY OF IDAHO · (Female)

NPI # 1376362038
Status Active
Credentials
Entity Individual
Enumeration date 10/08/2024
Last updated 10/08/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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