Organization
PEDIATRIC CARDIOLOGY OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY BAIRD (OFFICE MANAGER)
(208) 453-9962
Entity
Organization
Contact information
Practice address
900 N LIBERTY ST STE 206, BOISE, ID 83704-8729
(208) 453-9962
(208) 453-9963
Mailing address
2225 E SOLITUDE CT, BOISE, ID 83712-7576
(208) 453-9962
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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