Individual
VYTAS PETER SEMOGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N CECIL RD, POST FALLS, ID 83854-6200
(208) 262-2805
Mailing address
PO BOX 1829, COEUR D ALENE, ID 83816-1829
(208) 667-9334
(208) 664-2341
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M-5767
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M5767
ID LICENSE
ID
01
—
VPS MEDICAL IMAGING
COMPANY NAME
WA
Enumeration date
09/24/2006
Last updated
07/09/2007
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