Individual
CELSO R CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1522 17TH ST, LEWISTON, ID 83501-3652
(208) 743-8416
(208) 743-4642
Mailing address
1522 17TH ST, LEWISTON, ID 83501-3652
(208) 743-8416
(208) 743-4642
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5480
ID
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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