Individual
JOEL V DYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
203 S DAISY ST, SALMON, ID 83467-0000
(208) 756-5600
(208) 756-4169
Mailing address
203 S DAISY ST, SALMON, ID 83467-0000
(208) 756-5600
(208) 756-4169
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
015520
ME
207Q00000X
Family Medicine Physician
015520
ME
207Q00000X
Family Medicine Physician
Primary
M-5879
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027702
ANTHEM
—
01
—
AA26118
HARVARD PILGRIM
—
Enumeration date
10/26/2005
Last updated
09/12/2011
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