Individual
MICHELLE STODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2365 E GALA ST STE 1, MERIDIAN, ID 83642-4881
(208) 515-2654
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1620
ID
Other
Enumeration date
04/27/2018
Last updated
02/27/2023
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