Individual
DAVID E PARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 S 11TH AVE, SUITE 202, POCATELLO, ID 83201-4835
(208) 233-0801
(208) 233-0803
Mailing address
500 S 11TH AVE, SUITE 202, POCATELLO, ID 83201
(208) 233-0801
(208) 233-0803
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
M7334
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003882
BLUE SHIELD OF ID
ID
01
—
040011016
RR MEDICARE
ID
05
—
804258400
—
ID
01
—
DI361
BLUE CROSS OF ID
ID
01
—
M7334
STATE LICENSE
ID
Enumeration date
07/10/2006
Last updated
07/08/2007
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