Individual
PETAR G IGIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6140 W CURTISIAN AVE STE 200, BOISE, ID 83704-0107
(208) 302-0000
(208) 302-0055
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
49209-20
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
49209-020
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
M-17812
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053365494
—
WI
Enumeration date
05/20/2006
Last updated
10/02/2024
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