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Individual

MR. MARK A RASMUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD-PULM/SM

Contact information

Practice address
7272 POTOMAC, BOISE, ID 83704
(208) 884-2922
(208) 463-3044
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 463-3064

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-9630
ID
207R00000X
Internal Medicine Physician
M9630
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010157357
BLUE SHIELD
ID
01
76944
BLUE CROSS
ID
05
807530600
ID
Enumeration date
02/02/2007
Last updated
05/13/2016
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