Individual
ALEX TANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 E PARK BLVD, BOISE, ID 83712-7791
(208) 381-4100
Mailing address
1000 E PARK BLVD, BOISE, ID 83712-7791
(208) 381-4100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
113451300
WA
207R00000X
Internal Medicine Physician
M-14238
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2015
Last updated
05/07/2019
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