Individual
STEVEN J KOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1906 FAIRVIEW AVE STE 230, CALDWELL, ID 83605-5432
(208) 459-4667
(208) 459-3372
Mailing address
PO BOX 277976, ATLANTA, GA 30384-7976
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M6779
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002349300
—
ID
Enumeration date
05/24/2006
Last updated
01/28/2022
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