Organization
MAPLE GROVE EYECARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW D NEALE MD (PRACTICE OWNER/OPHTHALMOLOGIST)
(541) 687-1715
Entity
Organization
Contact information
Practice address
8955 W HACKAMORE DR, BOISE, ID 83709
(208) 344-7944
(208) 343-4676
Mailing address
8955 W HACKAMORE DR, BOISE, ID 83709-1673
(208) 344-7944
(208) 343-4676
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184885345
—
OR
Enumeration date
05/13/2019
Last updated
05/13/2019
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