Individual
CODY JAMES MARCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 W FORT ST, #111, BOISE, ID 83702-4501
(208) 380-2301
(208) 422-1319
Mailing address
500 W FORT ST, #111, BOISE, ID 83702-4501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MRM-1712
ID
207R00000X
Internal Medicine Physician
Primary
O-1532
ID
Other
Enumeration date
04/09/2018
Last updated
06/28/2022
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