Individual
MARK J. DELL'AGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2235 E GALA ST, MERIDIAN, ID 83642-8026
(208) 887-3724
(208) 887-1682
Mailing address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-6458
(208) 343-5031
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M-13433
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477656460
—
ID
Enumeration date
09/06/2006
Last updated
07/22/2019
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