Individual
DR. LEON WILLIAM NOWIERSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 WARM SPRINGS AVE, SUITE A, BOISE, ID 83712-6243
(208) 343-5910
(208) 384-8562
Mailing address
100 WARM SPRINGS AVE, SUITE A, BOISE, ID 83712-6243
(208) 343-5910
(208) 384-8562
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M4341
ID
207ND0101X
MOHS-Micrographic Surgery Physician
M4341
ID
207NS0135X
Procedural Dermatology Physician
M4341
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010021230
BLUE SHIELD OF IDAHO
ID
05
—
002586300
—
ID
01
—
43414
BLUE CROSS OF IDAHO
ID
Enumeration date
11/29/2006
Last updated
08/26/2022
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