Individual
MICHAEL MINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 HIGHLAND AVE, CLARKSTON, WA 99403-2829
(509) 758-5511
Mailing address
1319 7TH ST., LEWISTON, ID 83501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M4849
ID
207R00000X
Internal Medicine Physician
Primary
MD00022728
WA
Other
Enumeration date
08/19/2006
Last updated
06/04/2024
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