Individual
EDWARD J MACINERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 W IRONWOOD DR STE 320, COEUR D ALENE, ID 83814-4485
(208) 625-5250
(208) 625-5251
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5250
(208) 625-5251
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M-13060
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060060916
RAILROAD MEDICARE
MO
05
—
1053375105
—
ID
01
—
20007804
MEDICARE
—
01
—
27025013
BCBS-KC
MO
Enumeration date
04/14/2006
Last updated
07/24/2025
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