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Individual

ALBERT R TREARSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 HOSPITAL DR, KETCHUM, ID 83340
(208) 727-8800
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 727-8800

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
263133-1205
UT
207L00000X
Anesthesiology Physician
Primary
M-6845
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508864851
ID
Enumeration date
07/11/2005
Last updated
01/25/2016
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