Wynn, Donraphael
Wynn, Donraphael is an sole proprietor health care provider with primary practice located at 1072 N Liberty St Ste 303, Boise ID 83704. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Wynn, Donraphael can be contacted via phone (208) 302-4200.Contact Information
Primary practice address
1072 N Liberty St Ste 303
Boise ID 83704
Phone: (208) 302-4200
Fax: (208) 302-4255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 9164199-1205 | Utah |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | M-14403 | Idaho |
Profile Details
| NPI number | 1396188751 |
|---|---|
| LBN Legal business name | Wynn, Donraphael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 16th, 2013 |
| Last updated | Oct 24th, 2018 - about 7 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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