St Clair Specialty Physicians

LBN: St Clair Specialty Physicians
St Clair Specialty Physicians is an health care organization with primary practice located at 5610 Gage Street Suite A, Boise ID 83706. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as the primary health care specialty. St Clair Specialty Physicians can be contacted via phone (208) 367-3370, or through Provenzano, Robert via phone (313) 886-8787.

Contact Information

Primary practice address
5610 Gage Street Suite A Boise ID 83706
Phone: (208) 367-3370
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Provenzano, Robert Doctor of Medicine (MD)
Phone: (313) 886-8787

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X

Profile Details

NPI number 1063719292
LBN Legal business name St Clair Specialty Physicians
DBA Doing business as
Authorized official Provenzano, Robert Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 24th, 2011
Last updated Feb 24th, 2011 - about 15 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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