Individual
DR. MARK RYAN PAPENFUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1055 N CURTIS ROAD, BOISE, ID 83706-1309
(208) 367-2161
(208) 367-2989
Mailing address
PO BOX 9649, BOISE, ID 83707-4649
(208) 472-8100
(208) 472-8172
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
4081
IA
2085R0202X
Diagnostic Radiology Physician
125049736
IL
2085R0202X
Diagnostic Radiology Physician
4081
IA
2085R0202X
Diagnostic Radiology Physician
DO154120
OR
2085R0202X
Diagnostic Radiology Physician
Primary
O-0616
ID
2085U0001X
Diagnostic Ultrasound Physician
4081
IA
Other
Enumeration date
05/21/2007
Last updated
11/30/2011
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