Individual
SAMUEL ISHIMWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9428 W FAIRVIEW AVE, BOISE, ID 83704-8101
(208) 246-9902
Mailing address
723 S CORAL PL, BOISE, ID 83705-1262
(208) 801-2755
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
ID
Other
Enumeration date
12/12/2025
Last updated
12/12/2025
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