Individual
DR. MICHAEL R. DJERNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3197
(208) 463-3044
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3244
(208) 463-3388
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
M5756
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010001980
BLUE SHIELD
ID
01
—
000010034804
BLUE SHIELD
ID
05
—
002363800
—
ID
01
—
130007001
RAILROAD MEDICARE
ID
01
—
39594
BLUE CROSS
ID
01
—
45153
BLUE CROSS
ID
01
—
57562
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
08/13/2020
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