Individual
JULIE MARIE MADSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7301 W EMERALD ST, STE 102, BOISE, ID 83704-8688
(208) 321-8600
(208) 321-8626
Mailing address
7301 W EMERALD ST, STE 102, BOISE, ID 83704-8688
(208) 321-8600
(208) 321-8626
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-7940
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639287865
NPI
ID
01
—
204186533
TAX I.D. NUMBER
ID
01
—
B5612
BLUE CROSS
ID
Enumeration date
08/28/2006
Last updated
06/30/2010
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