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Individual

EDWARD R SETSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3200 CHANNING WAY STE A205, IDAHO FALLS, ID 83404-7586
(208) 535-4580
(208) 535-4520
Mailing address
PO BOX 277381, ATLANTA, GA 30384-7381

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
34713
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
M12737
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000023797
BCBS MOUNTAIN STATE
WV
05
0129142000
WV
05
0289272
OH
01
030028200
BLACK LUNG
WV
01
550357050
UNITED MINE WORKERS
WV
05
64942469
KY
Enumeration date
03/23/2006
Last updated
07/21/2022
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