Individual
GERTJAN MULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3301 N SAWGRASS WAY, BOISE, ID 83704-4493
(208) 375-0862
(208) 375-2658
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 375-0862
(208) 375-2658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4931
ID
Other
Enumeration date
04/20/2006
Last updated
01/23/2014
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