Organization
WILLIAM EDER MD
Active
Other names
PSC RADIATE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATIE DAVENPORT (BILLING)
(208) 520-2636
Entity
Organization
Contact information
Practice address
3040 E 17TH ST STE A, AMMON, ID 83406-6760
(208) 557-0998
Mailing address
3040 E 17TH ST STE A, AMMON, ID 83406-6760
(208) 557-0998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M3801
ID
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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