Individual
CHRISTIAN P VETSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3141
(208) 463-3044
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 463-3044
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6472
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003578
BLUE SHIELD
ID
01
—
000010027644
BLUE SHIELD
—
01
—
000010138645
BLUE SHIELD
—
05
—
002366500
—
ID
01
—
020023224
RAILROAD MEDICARE
—
01
—
14720
BLUE CROSS
ID
01
—
J66180
BLUE CROSS
ID
01
—
S5119
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
04/26/2013
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