Individual
DR. STEPHEN K KRONHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
M-6391
ID
208800000X
Urology Physician
Primary
M-6391
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010000609
REGENCE
ID
05
—
003782100
—
ID
01
—
20006147
NORIDIAN-MEDICARE
ID
01
—
4117-8
BLUECROSS
ID
Enumeration date
12/16/2005
Last updated
10/14/2015
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