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Individual

DR. GARY CANOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2993 N COLE RD, BOISE, ID 83704-5977
(208) 378-0400
(208) 378-7529
Mailing address
2993 N COLE RD, BOISE, ID 83704-5977
(208) 378-0400
(208) 378-7529

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4651
ID

Other

Enumeration date
07/24/2006
Last updated
07/09/2007
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