Individual
KAREN PORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1072 N LIBERTY STREET, STE 303, BOISE, ID 83704
(208) 367-2800
(208) 367-7111
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-2800
(208) 367-7111
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
8482
MT
2084N0400X
Neurology Physician
Primary
M-12653
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121828000
—
WY
Enumeration date
03/23/2006
Last updated
10/21/2014
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