Organization
TREASURE VALLEY GASTROENTEROLOGY SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL CROITORU M.D. (GASTROENTEROLOGIST)
(208) 467-3432
Entity
Organization
Contact information
Practice address
222 W IOWA AVE, SUITE A, NAMPA, ID 83686-6813
(208) 467-3432
(208) 467-4147
Mailing address
222 W IOWA AVE, SUITE A, NAMPA, ID 83686-6813
(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
—
000010006187
REGENCE BLUE SHIELD OF ID
ID
05
—
002701100
—
ID
01
—
84160
BLUE CROSS OF IDAHO
ID
Enumeration date
09/28/2006
Last updated
02/04/2013
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