Individual
NATHANIEL ORLAND STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-7350
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 236-7051
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
O-1507
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
04/29/2016
Last updated
10/09/2024
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