Kantayya, Vivek
Kantayya, Vivek is an individual health care provider with primary practice located at 300 S 23Rd St , Boise ID 83702-9100. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kantayya, Vivek can be contacted via phone (208) 344-3512.Contact Information
Primary practice address
300 S 23Rd St
Boise ID 83702-9100
Phone: (208) 344-3512
Fax: (208) 344-4898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036081072 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M-12703 | Idaho |
Profile Details
| NPI number | 1437132479 |
|---|---|
| LBN Legal business name | Kantayya, Vivek |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Jun 9th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437132479 | NPPES |
| Illinois | MEDICAID | 036081072 |
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