Individual
GERARDO MIDENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 IDAHO STREET, LEWISTON, ID 83501
(208) 743-7427
(208) 743-7121
Mailing address
PO BOX 816, LEWISTON, ID 83501-0816
(208) 743-2511
(208) 799-5528
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
M-8750
ID
207RX0202X
Medical Oncology Physician
MD00042019
WA
Other
Enumeration date
05/19/2006
Last updated
05/16/2014
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