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Individual

DR. TERRENCE MICHAEL RAGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
PORTNEUF MEDICAL CENTER, 777 HOSPITAL WAY, SOUTH MOB, SUITE 201, POCATELLO, ID 83201
(208) 239-2620
(208) 239-3778
Mailing address
777 HOSPITAL WAY STE 201, SOUTH MEDICAL OFFICE BUILDING, STE 201, POCATELLO, ID 83201-5175
(208) 239-2620
(208) 239-3778

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M-13764
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
808437000
ID
Enumeration date
05/06/2010
Last updated
06/11/2019
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