Dettwiler, Carl Ray
Dettwiler, Carl Ray is an individual health care provider with primary practice located at 2517 17Th Sreet Suite B, Lewiston ID 83501-0001. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Dettwiler, Carl Ray can be contacted via phone (208) 743-4373.Contact Information
Primary practice address
2517 17Th Sreet Suite B
Lewiston ID 83501-0001
Phone: (208) 743-4373
Fax: (208) 743-3369
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | M5110 | Idaho |
Profile Details
| NPI number | 1285623819 |
|---|---|
| LBN Legal business name | Dettwiler, Carl Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2005 |
| Last updated | Dec 16th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285623819 | NPPES |
| Idaho | MEDICAID | 806979100 |
Popular Providers
-
Look, Fred
5141 Dixie Hwy Suite 104, Louisville KY 40216-1765 -
Deshmukh, Sanjay Vijay
1625 E 17Th St Ste. 100, Santa Ana CA 92705-8517 -
Rossacci, Joseph P
600 Clark Rd , Tewksbury MA 01876-1699 -
Felker, Richard
5655 Hudson Dr Ste 210 Aris Radiology, Hudson OH 44236-4455 -
Thorne, Gary Marvin
307 Saint Johns Way Suite 5, Lewiston ID 83501-2435 -
Parent, Michael K
1630 23Rd Ave Suite 701, Lewiston ID 83501-6350 -
Modi, Rajendra Kumar
55-44 Metropolitan Avenue , Ridgewood NY 11385 -
Joseph, Stuart K
9299 Coral Reef Dr , Village Of Palmetto Bay FL 33157-1775