Individual
DR. MARVIN RENELL KYM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 W A ST, MOSCOW, ID 83843-4042
(208) 883-1135
(208) 892-0174
Mailing address
PO BOX 8007, MOSCOW, ID 83843-0507
(208) 882-4511
(208) 883-6580
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M6029
ID
207X00000X
Orthopaedic Surgery Physician
WA0029535
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003567
REGENCE
ID
05
—
003782400
—
ID
01
—
10298
BCI
ID
05
—
8138554
—
WA
Enumeration date
09/13/2005
Last updated
07/19/2024
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