Individual
LUCIE A DIMAGGIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2550 ADDISON AVE E, SUITE E, TWIN FALLS, ID 83301-6749
(208) 814-7780
(208) 814-7746
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8289
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806143900
—
ID
01
—
P00029389
RR MEDICARE
ID
Enumeration date
06/06/2006
Last updated
12/10/2014
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