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Individual

ANDREA H THOMPSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
745 S PROGRESS AVE, MERIDIAN, ID 83642-5619
(208) 884-2900
(208) 884-2979
Mailing address
217 W GEORGIA AVE, SUITE 115, NAMPA, ID 83686-6811
(208) 463-3000
(208) 463-3034

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5783
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010001385
BLUE SHIELD
ID
01
000010001386
BLUE SHIELD
ID
01
000010001387
BLUE SHIELD
ID
01
38752
BLUE CROSS
ID
01
43067
BLUE CROSS
ID
01
57380
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
07/08/2007
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