Individual
MRS. JANET M CEGNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1055 N CURTIS RD, GEM STATE RADIOLOGY, BOISE, ID 83706-1309
(208) 367-8855
Mailing address
PO BOX 9649, BOISE, ID 83707-4649
(208) 472-8100
(208) 472-8172
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M-6257
ID
2085R0202X
Diagnostic Radiology Physician
MD18267
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003639600
MEDICAID
ID
01
—
004837002
BLUE CROSS
OR
05
—
058052
—
OR
Enumeration date
05/09/2006
Last updated
03/28/2023
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