Individual
VICTORIA H GOLTRY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 463-3034
Mailing address
217 W GEORGIA AVE, STE 115, NAMPA, ID 83686-6811
(208) 463-3000
(208) 463-3034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7895
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010027475
BLUE SHIELD
ID
01
—
000010027476
BLUE SHIELD
ID
01
—
36483
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
07/08/2007
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