Individual
TYLER M BURPEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E IDAHO ST, STE 316, BOISE, ID 83712-6267
(208) 381-7310
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
228002
MA
2080P0206X
Pediatric Gastroenterology Physician
Primary
M11332
ID
2080P0206X
Pediatric Gastroenterology Physician
MD0004285
WA
Other
Enumeration date
07/10/2006
Last updated
07/30/2013
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