Individual
DR. MARK S MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W. FORT ST., MAIL CODE 111, BOISE, ID 83702-6241
(208) 422-1325
(208) 422-1319
Mailing address
500 W. FORT ST., MAIL CODE 111, BOISE, ID 83702-6241
(208) 422-1325
(208) 422-1319
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
M9326
ID
2080P0203X
Pediatric Critical Care Medicine Physician
M9326
ID
Other
Enumeration date
08/26/2005
Last updated
03/23/2022
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