Individual
HIRA SIKTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4511 ZEBE AVE, CHUBBUCK, ID 83202-4707
(208) 904-4780
(208) 904-4832
Mailing address
4511 ZEBE AVE, CHUBBUCK, ID 83202-4707
(208) 904-4780
(208) 904-4832
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD437511
PA
207RN0300X
Nephrology Physician
M12398
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477790962
—
ID
Enumeration date
01/21/2009
Last updated
12/08/2022
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