Individual
RAQUEL CROITORU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
222 W IOWA AVE STE A, NAMPA, ID 83686-6814
(208) 467-3432
(208) 467-4147
Mailing address
222 W IOWA AVE STE A, NAMPA, ID 83686-6814
(208) 467-3432
(208) 467-4147
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M-5744
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004790
REGENCE BLUE SHIELD OF ID
ID
05
—
002701100
—
ID
01
—
57448
BLUE CROSS OF IDAHO
ID
01
—
820451495
TAX I.D. NUMBER
ID
Enumeration date
09/07/2006
Last updated
02/05/2013
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