Individual
DECLAN P O'RIORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2088
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2088
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
M9130
ID
Other
Enumeration date
06/04/2006
Last updated
09/11/2012
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