Individual
DR. KIMBERLY KAHLER STUTZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6042
(208) 322-7018
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6042
(208) 322-7018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M9972
ID
207Q00000X
Family Medicine Physician
MD0031115
WA
207Q00000X
Family Medicine Physician
MD19694
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805823200
—
ID
05
—
8159519
—
WA
Enumeration date
08/19/2005
Last updated
06/09/2009
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