Individual
DR. RAYMOND WILLIAM GRAMS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712
(208) 706-5000
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 706-5000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
9360238-1204
UT
2084N0400X
Neurology Physician
O-1158
ID
2084N0400X
Neurology Physician
R1938
AZ
2084V0102X
Vascular Neurology Physician
Primary
O-1158
ID
Other
Enumeration date
09/06/2011
Last updated
08/12/2021
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