Organization
PEDIATRIC SURGERY OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN CURNOW MD (PRES)
(208) 345-5400
Entity
Organization
Contact information
Practice address
100 E IDAHO ST STE 300, BOISE, ID 83712-6269
(208) 345-5400
(208) 345-5454
Mailing address
100 E IDAHO ST STE 300, BOISE, ID 83712-6269
(208) 345-5400
(208) 345-5454
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010018063
BLUE SHIELD GROUP #
ID
01
—
8C683
BLUE CROSS GROUP #
ID
Enumeration date
04/02/2007
Last updated
08/22/2020
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