Individual
SUHREI ACEVEDO-DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 2ND ST, MELBA, ID 83641-5199
(208) 495-1011
(208) 495-1012
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 495-1011
(208) 495-1012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-11831
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215106695
—
ID
Enumeration date
05/01/2006
Last updated
01/08/2019
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