Individual
MEL BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
220 BANNOCK ST, MALAD CITY, ID 83252-5068
(208) 766-2600
(208) 766-4258
Mailing address
220 BANNOCK ST, MALAD CITY, ID 83252-5068
(208) 766-2600
(208) 766-4258
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
757
AK
363A00000X
Physician Assistant
Primary
PA-1173
ID
Other
Enumeration date
03/02/2007
Last updated
12/08/2025
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