Individual
JOHN CALOMENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 N FLUME ST, BOISE, ID 83712-6318
(208) 918-0478
Mailing address
211 N FLUME ST, BOISE, ID 83712-6318
(208) 918-0478
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G3208
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053350744
NPI NUMBER
ID
05
—
138249115
—
TX
Enumeration date
06/06/2006
Last updated
11/22/2016
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