Organization
MARK A SPELICH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI J SARICH (OFFICE MANAGER)
(208) 855-2410
Entity
Organization
Contact information
Practice address
6590 W NORWOOD DR, BOISE, ID 83704
(208) 855-2410
(208) 855-0157
Mailing address
6590 W NORWOOD DR, BOISE, ID 83704
(208) 855-2410
(208) 855-0157
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M9278
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151179
REGENCE BLUE SHIELD #
ID
01
—
74880
BLUE CROSS OF IDAHO #
ID
05
—
807210200
—
ID
Enumeration date
02/22/2007
Last updated
05/08/2008
Update your record
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