FUNCTIONAL AND INTEGRATIVE MEDICINE OF IDAHO PA NPI 1740524701

NPI Information

FUNCTIONAL AND INTEGRATIVE MEDICINE OF IDAHO PA is a family medicine in Boise, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FUNCTIONAL AND INTEGRATIVE MEDICINE OF IDAHO PA NPI is 1740524701. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3858 N GARDEN CENTER WAY
SUITE 100
BOISE, ID
ZIP 83703-008
Phone: (208) 385-7711
Fax: (208) 385-0346

The provider's authorized official is Gail M. Eberharter .
The authorized official title is President and has the following contact phone number (208) 863-1399.

The CLIA number assigned to this NPI record is 13D2230426 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2012 and was last updated on 1/29/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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