Individual
MICHAEL K PARENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1630 23RD AVE, SUITE 701, LEWISTON, ID 83501-6350
(208) 743-3998
(208) 746-4879
Mailing address
1630 23RD AVE, SUITE 701, LEWISTON, ID 83501-6350
(208) 743-3998
(208) 746-4879
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M4475
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001224600
—
ID
Enumeration date
10/17/2005
Last updated
05/01/2008
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