Individual
MR. KERRY W SAUREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1218 9TH ST, STE 7, RUPERT, ID 83350
(208) 436-3161
(208) 436-3163
Mailing address
1218 9TH ST, STE 7, RUPERT, ID 83350
(208) 436-3161
(208) 436-3163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4817
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010000787
BLUE SHIELD
ID
05
—
02263400
—
ID
01
—
48173
BLUE CROSS
ID
Enumeration date
07/08/2006
Last updated
06/22/2010
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