Individual
DR. MIKAEL D LAGWINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3277 E LOUISE DR STE 350, MERIDIAN, ID 83642-5510
(208) 887-9500
(208) 887-9800
Mailing address
998 E SHADOW CREEK LN, EAGLE, ID 83616-2750
(903) 241-1474
(903) 232-8226
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
M-9599
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-9599
IDAHO BOARD OF MEDICINE
ID
Enumeration date
03/02/2006
Last updated
02/28/2019
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