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Individual

JAMES R DZUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
217 W GEORGIA AVE, SUITE 115, NAMPA, ID 83686-6811
(208) 463-3000
(208) 463-3034
Mailing address
217 W GEORGIA AVE, SUITE 115, NAMPA, ID 83686-6811
(208) 463-3000
(208) 463-3034

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5982
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010001073
BLUE SHIELD
ID
01
59824
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
07/09/2007
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