Individual
DR. STEPHEN E SPENCER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6565 W EMERALD ST, BOISE, ID 83704-8737
(208) 377-5055
(208) 377-5335
Mailing address
6565 W EMERALD ST, BOISE, ID 83704-8737
(208) 377-5055
(208) 377-5335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M3666
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002762400
—
ID
Enumeration date
06/16/2005
Last updated
10/05/2012
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