Individual
RICHARD RADNOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4850 N ROSEPOINT WAY, STE 100, BOISE, ID 83713
(208) 939-2100
Mailing address
4850 N ROSEPOINT WAY, STE 100, BOISE, ID 83713
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
O-259
ID
208VP0000X
Pain Medicine Physician
O-259
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806047900
—
ID
Enumeration date
10/11/2006
Last updated
10/28/2019
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