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Individual

MR. MARK MITCHELL ROUBIDOUX II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
336 WARNER DR STE 4A, LEWISTON, ID 83501-4441
(208) 305-3537
(877) 376-4040
Mailing address
320 E NEIDER AVE STE 103, COEUR D ALENE, ID 83815-6007
(208) 930-4944
(877) 376-4040

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
39235
ID

Other

Enumeration date
09/28/2020
Last updated
09/12/2025
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