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Individual

MARK B CHENEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3025 W CHERRY LANE, MERIDIAN, ID 83642
(208) 302-6400
(208) 302-6455
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 302-6400
(208) 302-6455

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O0680
ID
208D00000X
General Practice Physician
58003156
OH

Other

Enumeration date
08/28/2009
Last updated
01/09/2019
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