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Individual

DANIEL J WEGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2161
(208) 367-2989
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M8601
ID
2085R0202X
Diagnostic Radiology Physician
MD153171
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806390500
ID
Enumeration date
05/15/2006
Last updated
01/05/2026
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