# NINON GERMAIN MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104135375
- **Authorized official:** MS. ALISON DUNBAR (REIMBURSEMENT MANAGER)
- **Authorized official phone:** (208) 323-1125

## Contact information

- **Practice address:** 413 N ALLUMBAUGH ST STE 101, BOISE, ID 83704-9219
- **Practice address phone:** (208) 323-1125
- **Practice address fax:** (208) 323-9604
- **Mailing address:** 413 N ALLUMBAUGH ST STE 101, BOISE, ID 83704-9219
- **Mailing address phone:** (208) 323-1125
- **Mailing address fax:** (208) 323-9604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | M8955 | ID | Yes |

## Other

- **Enumeration date:** 10/05/2010
- **Last updated:** 12/27/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1550780 | PTAN | ID |