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Individual

CHUCK LEE NEWHOUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6641 KANIKSU ST, BONNERS FERRY, ID 83805-7532
(208) 267-3655
Mailing address
PO BOX 1640, BONNERS FERRY, ID 83805-1640

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7989
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M7989
STATE LICENSE NUMBER
ID
Enumeration date
07/09/2006
Last updated
03/07/2023
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