Individual
DEMITRI CARAHALIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1311 E CENTRAL DR, MERIDIAN, ID 83642-7991
(720) 940-1562
Mailing address
2709 N 28TH ST, BOISE, ID 83703-5417
(720) 940-1562
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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