Organization
STERLING PROVIDER GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORBIN BUNNAGE (OWNER)
(208) 542-9111
Entity
Organization
Contact information
Practice address
1737 S MERIDIAN RD, MERIDIAN, ID 83642
(986) 256-8880
(986) 256-8881
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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