Individual
DR. PETER M CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 S WOODRUFF AVE, SUITE 4, IDAHO FALLS, ID 83404-6374
(208) 524-4511
(208) 524-4540
Mailing address
2001 S WOODRUFF AVE, SUITE 4, IDAHO FALLS, ID 83404-6374
(208) 524-4511
(208) 524-4540
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M-3494
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002502000
—
ID
Enumeration date
09/09/2005
Last updated
04/06/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us