Individual
LAUREN MYER SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6259 W EMERALD ST, BOISE, ID 83704
(208) 489-1900
Mailing address
6259 W EMERALD ST, BOISE, ID 83704-8731
(678) 793-4626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
68952
GA
207RG0100X
Gastroenterology Physician
Primary
68952
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003178041A
—
GA
Enumeration date
04/13/2010
Last updated
07/21/2022
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