Individual
MARK CHRISTIAN WALSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 W IRONWOOD DR STE 101, COEUR D ALENE, ID 83814-2464
(208) 667-4557
(208) 765-2887
Mailing address
1919 LINCOLN WAY STE 315, COEUR D ALENE, ID 83814-2527
(208) 625-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M16095
ID
Other
Enumeration date
06/05/2019
Last updated
04/17/2024
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