Enomoto, Dennis M

Enomoto, Dennis M is an individual health care provider with primary practice located at 775 Pole Line Rd W Suite 112, Twin Falls ID 83301-5814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Enomoto, Dennis M can be contacted via phone (208) 814-8200.

Contact Information

Primary practice address
775 Pole Line Rd W Suite 112 Twin Falls ID 83301-5814
Phone: (208) 814-8200
Fax: (208) 933-4921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X M9612 Idaho

Profile Details

NPI number 1649226127
LBN Legal business name Enomoto, Dennis M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Dec 29th, 2014 - about 12 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 1649226127 NPPES
Idaho MEDICAID 807509100
Idaho Other P00431080

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