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Individual

KAREN D LIBSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
229 S 8TH ST, ST MARIES, ID 83861-1813
(208) 245-2591
(208) 245-5246
Mailing address
229 S 8TH ST, ST MARIES, ID 83861-1813
(208) 245-2591
(208) 245-5246

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41146
CO
207Q00000X
Family Medicine Physician
Primary
M-10876
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114996428
PREMERA BLUE CROSS
WA
05
40984524
CO
01
78176
BLUE CROSS OF IDAHO
ID
05
808521300
ID
Enumeration date
03/17/2006
Last updated
01/12/2010
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