Individual
MATTHEW PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LAKESIDE PEDIATRIC & ADOLESCENT MEDICINE, 980 W IRONWOOD DRIVE SUITE 302, COEUR D'ALENE, ID 83814
(310) 267-9129
Mailing address
LAKESIDE PEDIATRIC & ADOLESCENT MEDICINE, 980 W IRONWOOD DRIVE SUITE 302, COEUR D'ALENE, ID 83814
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M14323
ID
Other
Enumeration date
03/30/2015
Last updated
04/10/2019
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