Individual
RICHARD ALAN BLATTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2001 S WOODRUFF AVE STE 4, IDAHO FALLS, ID 83404-6371
(208) 524-4511
(208) 524-4540
Mailing address
2375 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 552-1234
(208) 524-4540
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
5101019997
MI
208800000X
Urology Physician
5315055574
MI
208800000X
Urology Physician
Primary
O-1041
ID
208800000X
Urology Physician
O-1041
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154682565
—
MI
01
—
O-1041
IDAHO STATE LICENSE
ID
Enumeration date
06/01/2012
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us