Individual
NELSON ANTONIUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6509 HIGHWAY 2 STE 101, PRIEST RIVER, ID 83856-6609
(208) 448-2321
(208) 448-1317
Mailing address
PO BOX 2160, SANDPOINT, ID 83864-0908
(208) 263-7101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD00040823
WA
207Q00000X
Family Medicine Physician
Primary
M-13097
ID
Other
Enumeration date
06/18/2006
Last updated
02/17/2022
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