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Individual

DR. TODD M WALDMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2855 E MAGIC VIEW DR, MERIDIAN, ID 83642-6245
(208) 639-4900
(208) 639-4901
Mailing address
2855 E MAGIC VIEW DR, MERIDIAN, ID 83642-6245
(208) 639-4900
(208) 639-4901

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M-7595
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010004760
BLUE SHIELD BOISE
ID
01
000010157306
BLUE SHIELD MERIDIAN
ID
01
76711
BLUE CROSS MERIDIAN
ID
05
805249200
ID
01
B4893
BLUE CROSS BOISE
ID
01
P00250287
RAILROAD MEDICARE
ID
Enumeration date
05/13/2006
Last updated
02/22/2021
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