Individual
JOSHUA BERLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222
Mailing address
3080 E GENTRY WAY STE 210, MERIDIAN, ID 83642-3013
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M14174
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2015
Last updated
06/10/2018
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