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Individual

DR. LUCIANO COSTA AMADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
287 W JEFFERSON ST, BOISE, ID 83702-6045
(208) 322-1680
Mailing address
190 E BANNOCK ST STE W200, BOISE, ID 83712-6241
(208) 381-8752

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
107201
MN
207RC0001X
Clinical Cardiac Electrophysiology Physician
107201
MN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
M-17240
ID

Other

Enumeration date
07/13/2007
Last updated
06/27/2023
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