Individual
DOMINIC HARAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 232-7862
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRM-2300
ID
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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