Individual
SULABHA CHAGANABOYANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
315 E ELM ST # 201, CALDWELL, ID 83605-4857
(208) 514-2528
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26025
WV
207Q00000X
Family Medicine Physician
94-07773
KS
207Q00000X
Family Medicine Physician
Primary
M13891
ID
Other
Enumeration date
07/05/2011
Last updated
10/21/2025
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