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Individual

TYLER T BIRCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
520 S EAGLE RD STE 3102, MERIDIAN, ID 83642-6352
(208) 706-5100
Mailing address
500 W FORT ST # 111R, BOISE, ID 83702-4501

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
O-1272
ID
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/22/2016
Last updated
04/09/2020
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