Individual
TEVYN D KAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W FORT ST # 111R, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W FORT ST # 111R, BOISE, ID 83702-4501
(208) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MRM-2367
ID
207R00000X
Internal Medicine Physician
PG215556
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG215556
OR
Other
Enumeration date
04/07/2023
Last updated
05/30/2025
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