Individual
DR. SHAWN CHRISTIAN NOWIERSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
197 W STATE ST, EAGLE, ID 83616-4959
(208) 938-9817
Mailing address
932 HEARTHSTONE DR, BOISE, ID 83702-1826
(208) 331-9358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7050
ID
Other
Enumeration date
05/12/2006
Last updated
11/27/2012
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