Individual
GAVIN S YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 LINCOLN WAY, SUITE 415, COEUR D ALENE, ID 83814-2527
(208) 625-4595
(208) 625-4596
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M7978
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805774200
—
ID
Enumeration date
11/07/2006
Last updated
10/06/2016
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