Individual
MARTHA I BUITRAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3614 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 535-8400
(208) 535-8409
Mailing address
3614 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 535-8400
(208) 535-8409
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
M-8675
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806532100
—
ID
Enumeration date
07/12/2005
Last updated
10/05/2022
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