Organization
BONNIE KIM WAITE, M.D. CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONNIE-KIM WAITE M.D. (PROVIDER)
(208) 343-1702
Entity
Organization
Contact information
Practice address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-6458
(208) 343-5031
Mailing address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-1702
(208) 342-7042
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M-7308
ID
Other
Enumeration date
07/18/2007
Last updated
07/19/2019
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