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Individual

MICHAEL JOSEPH SUIDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1352
(208) 367-6416
Mailing address
PO BOX 4268, PORTLAND, OR 97208-4268
(503) 372-2740
(503) 372-2754

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N32502
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA559
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806738300
ID
Enumeration date
05/25/2006
Last updated
04/08/2011
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