Individual
MICHAEL ANDREW MCISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1327 SUPERIOR ST, SANDPOINT, ID 83864-1735
(208) 263-7101
Mailing address
1327 SUPERIOR ST, SANDPOINT, ID 83864-1735
(208) 263-7101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA426
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806796300
—
ID
Enumeration date
05/24/2006
Last updated
04/19/2010
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