Meulenberg, Daniel Jack

Meulenberg, Daniel Jack is an individual health care provider with primary practice located at 606 N 3Rd Ave Ste 101 , Sandpoint ID 83864-1594. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Meulenberg, Daniel Jack can be contacted via phone (208) 263-1435.

Contact Information

Primary practice address
606 N 3Rd Ave Ste 101 Sandpoint ID 83864-1594
Phone: (208) 263-1435
Fax: (208) 263-7812
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M5882 Idaho

Profile Details

NPI number 1043217599
LBN Legal business name Meulenberg, Daniel Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Jan 22nd, 2020 - about 6 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 1043217599 NPPES
Idaho MEDICAID 002792600

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