Individual
NATHAN JAMES RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3025 W CHERRY LANE, STE B, MERIDIAN, ID 83642
(208) 302-6400
(208) 302-6455
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-6400
(208) 302-6455
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1440
ID
363AM0700X
Medical Physician Assistant
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—
Other
Enumeration date
10/19/2016
Last updated
11/23/2016
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