Individual
JOHANNES D VELDHUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S EAGLE RD, SUITE 1234, MERIDIAN, ID 83642-6351
(208) 429-0300
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
22270
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477530335
—
ID
05
—
347197700
—
MN
01
—
460003751
RAILROAD
MN
Enumeration date
12/30/2005
Last updated
01/09/2015
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