Individual
D PETER REEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. P.A.
Contact information
Practice address
999 N CURTIS, #307, BOISE, ID 83706-1333
(208) 367-7500
(208) 367-7506
Mailing address
999 N CURTIS RD, #307, BOISE, ID 83706-1336
(208) 367-7500
(208) 367-7506
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M-5296
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DL141
BLUE CROSS PROVIDER #
ID
Enumeration date
08/02/2005
Last updated
01/23/2008
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