Individual
DR. JEREMY DAVID WALDRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 N CURTIS RD STE 303, BOISE, ID 83706-1347
(208) 377-4000
Mailing address
1000 N CURTIS RD STE 303, BOISE, ID 83706-1347
(208) 377-4000
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
M-15024
ID
207R00000X
Internal Medicine Physician
01069478A
IN
Other
Enumeration date
06/17/2009
Last updated
10/27/2020
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