Individual
DR. CHRISTOPHER MARK CARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Mailing address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPD-579
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015187
REGENCE BLUE SHIELD OF ID
ID
05
—
002523400
—
ID
01
—
0396900001
DMERC
ID
01
—
2309310-01
BLUE CROSS OF OREGON
ID
01
—
V5608
BLUE CROSS OF IDAHO
ID
Enumeration date
04/14/2006
Last updated
01/04/2010
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