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Individual
THEODORE W COLWELL
Active
Individual
THEODORE W COLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D93712
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
M-4462
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003390
REGENCE BLUE SHIELD OF ID
ID
05
—
003644200
—
ID
05
—
291948
—
OR
01
—
44628
BLUE CROSS OF IDAHO
ID
Enumeration date
01/24/2006
Last updated
01/06/2022
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