Individual
DR. MICHAEL TODD BURTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
531 4TH AVE, LEWISTON, ID 83501-2450
(208) 743-4393
Mailing address
531 4TH AVE, LEWISTON, ID 83501-2450
(208) 743-4393
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M13009
ID
2085R0202X
Diagnostic Radiology Physician
MD 13873
HI
Other
Enumeration date
07/20/2006
Last updated
04/11/2016
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