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Individual

JOEL C SWANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
323 E RIVERSIDE DR, SUITE 224, SAMG EHP FAMILY MEDICINE, EAGLE, ID 83616-6815
(208) 302-6000
(208) 302-6055
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5180
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8006
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805814100
ID
Enumeration date
06/06/2006
Last updated
10/15/2024
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