Individual
MICHELE B EBBERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6273
(208) 381-6196
(208) 381-6199
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
2006-00886
NC
2088P0231X
Pediatric Urology Physician
Primary
M11717
ID
Other
Enumeration date
06/27/2006
Last updated
08/29/2019
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