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Organization
MICHAEL E. ESTESS, M. D. CHARTERED
Active
Organization
MICHAEL E. ESTESS, M. D. CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E. ESTESS M. D. (PRESIDENT)
(208) 345-2630
Entity
Organization
Contact information
Practice address
1471 SHORELINE DR, SUITE 119, BOISE, ID 83702-6879
(208) 345-2630
(208) 345-6504
Mailing address
1471 SHORELINE DR, SUITE 119, BOISE, ID 83702-6879
(208) 345-2630
(208) 345-6504
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
M-3173
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003612
BLUE SHIELD
ID
01
—
DG399
BLUE CROSS
ID
Enumeration date
04/12/2007
Last updated
08/22/2020
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