Individual
DR. LLOYD E. WITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Mailing address
1107 W IRONWOOD DR, COEUR D ALENE, ID 83814-2604
(208) 667-7459
(208) 667-2631
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M5216
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002626200
—
ID
01
—
200004982
RAILROAD MEDICARE
ID
Enumeration date
09/21/2005
Last updated
10/29/2010
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