Individual
DR. IKE D TANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6259 W EMERALD ST, BOISE, ID 83704-8731
(208) 489-1900
(208) 375-5286
Mailing address
6259 W EMERALD ST, BOISE, ID 83704-8731
(208) 489-1900
(208) 375-5286
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M5803
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003976400
—
ID
Enumeration date
03/02/2006
Last updated
08/31/2011
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