Individual
SEAN CRAIG STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 N CURTIS RD STE 100, BOISE, ID 83706-1339
(208) 378-0080
Mailing address
901 N CURTIS RD STE 100, BOISE, ID 83706-1339
(208) 378-0080
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
2020009905
MO
207K00000X
Allergy & Immunology Physician
Primary
M-16211
ID
208000000X
Pediatrics Physician
2017021058
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
03/27/2023
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