Organization
IDAHO OCCUPATIONAL MEDICINE GROUP
Active
Other names
Coeur d Alene Spine and Sport
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALAN LUDWIG MD (OWNER)
(208) 765-0156
Entity
Organization
Contact information
Practice address
1839 N GOVERNMENT WAY, COEUR D ALENE, ID 83814-3454
(208) 765-0156
(208) 292-3177
Mailing address
1839 N GOVERNMENT WAY, COEUR D ALENE, ID 83814-3454
(208) 765-0156
(208) 292-3177
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245330208
—
ID
Enumeration date
02/19/2019
Last updated
08/25/2021
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