Organization
IDAHO VASCULAR INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL WEGNER M.D. (MEMBER)
(208) 288-4620
Entity
Organization
Contact information
Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 288-4620
Mailing address
PO BOX 9649, BOISE, ID 83707-4649
(208) 472-8116
(208) 344-1926
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
07/01/2006
Last updated
08/26/2007
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