Individual
NATHAN J HIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 W STATE ST, STE 100, EAGLE, ID 83616
(208) 939-1035
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G84579
CA
208000000X
Pediatrics Physician
Primary
M11639
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G845790
—
CA
Enumeration date
10/25/2006
Last updated
12/29/2012
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