Idaho Urologic Institute Pa

LBN: Idaho Urologic Institute Pa
Idaho Urologic Institute Pa is an health care organization with primary practice located at 2855 E Magic View Dr , Meridian ID 83642-6245. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Idaho Urologic Institute Pa can be contacted via phone (208) 639-4900, or through Waldamann, Todd via phone (208) 343-7736.

Contact Information

Primary practice address
2855 E Magic View Dr Meridian ID 83642-6245
Fax: (208) 639-4939
Website:
Authorized official contact:
Name: Waldamann, Todd Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X

Profile Details

NPI number 1689620692
LBN Legal business name Idaho Urologic Institute Pa
DBA Doing business as
Authorized official Waldamann, Todd Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 25th, 2006
Last updated Feb 22nd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689620692 NPPES
Idaho MEDICAID 807277400
Idaho Other 8M783
Idaho Other DD7372
Idaho Other 8M152
Idaho Other 000010006729
Idaho Other 000010152026
Idaho Other 8M879
Idaho Other 000010152026

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