Cleverly, Chad William

Cleverly, Chad William is an individual health care provider with primary practice located at 3293 N Milwaukee St , Boise ID 83704-4446. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cleverly, Chad William can be contacted via phone (208) 322-2020.

Contact Information

Primary practice address
3293 N Milwaukee St Boise ID 83704-4446
Phone: (208) 322-2020
Fax: (208) 322-1192
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-1015 Idaho

Profile Details

NPI number 1386660959
LBN Legal business name Cleverly, Chad William
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386660959 NPPES
Idaho Other 000010015598 BLUE SHIELD
Idaho Other 0198230001 BLUE SHIELD
Idaho Other V3967 BLUE SHIELD

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