Individual
CHARLES W COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706
(208) 367-6995
(208) 367-6953
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 367-6995
(208) 367-6953
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04-37537
KS
207Q00000X
Family Medicine Physician
9408267
KS
208000000X
Pediatrics Physician
M-14360
ID
Other
Enumeration date
07/22/2013
Last updated
02/12/2021
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