Individual
JOHN P JAMBURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7722 USTICK RD, BOISE, ID 83704-5845
(208) 322-1325
Mailing address
7722 USTICK RD, BOISE, ID 83704-5845
(208) 322-1325
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M4468
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M4468
STATE LICENSE #
ID
Enumeration date
06/06/2006
Last updated
07/08/2007
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