Organization
SILVER VALLEY EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GATEWOOD MD (OWNER)
(800) 355-0808
Entity
Organization
Contact information
Practice address
3 JACOBS GULCH ROAD, KELLOGG, ID 83837
(208) 784-1221
Mailing address
PO BOX 8120, PHILADELPHIA, PA 19101-8120
(800) 444-7009
(800) 305-3233
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010145844
BLUE SHIELD
ID
01
—
8I219
BLUE CROSS
ID
Enumeration date
10/31/2007
Last updated
04/20/2008
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