# PERPETUAL FAMILY MEDICINE

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

## Provider details

- **NPI number:** 1194533992
- **Authorized official:** MARK CHRISTOPHER MARTINDALE PA-C (OWNER/PROVIDER)
- **Authorized official phone:** (208) 480-6174

## Contact information

- **Practice address:** 1717 LINCOLN WAY STE 108, COEUR D ALENE, ID 83814-2556
- **Practice address phone:** (208) 480-6174
- **Practice address fax:** (208) 601-6174
- **Mailing address:** 1717 LINCOLN WAY STE 108, COEUR D ALENE, ID 83814-2556
- **Mailing address phone:** (208) 480-6174
- **Mailing address fax:** (208) 601-6174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/26/2024
- **Last updated:** 03/03/2025