Individual
MR. FRED ELMER GIOVANINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
505 1ST STREET, SUITE A, IDAHO FALLS, ID 83401
(208) 525-6002
(208) 232-2558
Mailing address
505 1ST ST, SUITE A, IDAHO FALLS, ID 83401-3929
(208) 525-6002
(208) 232-2558
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD35
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010009728
BLUE SHIELD OF IDAHO
ID
01
—
0005553418
AETNA
KY
05
—
002725400
—
ID
01
—
0041
DELTA DENTAL OF IDAHO
ID
01
—
1650686
UNITED CONCORDIA
PA
01
—
753354100000
PREMERA BLUE CROSS
WA
01
—
GD203
BLUE CROSS OF IDAHO
ID
Enumeration date
07/27/2009
Last updated
07/27/2009
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