Individual
DR. MICHAEL ROONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
(208) 799-5528
Mailing address
PO BOX 816, LEWISTON, ID 83501-0816
(208) 743-2511
(208) 799-5528
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
M-4745
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002649400
—
ID
01
—
10004623
REGENCE OF IDAHO
ID
05
—
8616708
—
WA
01
—
HB112
BLUE CROSS OF IDAHO
ID
Enumeration date
06/02/2006
Last updated
07/09/2007
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