Individual
DR. NIC R CORDUM
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
M6979
ID
Other
Enumeration date
03/03/2006
Last updated
09/07/2007
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