Individual
ANTHONY J BRANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E MULLAN AVENUE, OSBURN, ID 83849-0707
(208) 556-4803
(208) 556-1023
Mailing address
PO BOX 707, OSBURN, ID 83849-0707
(208) 556-4803
(208) 556-1023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-6860
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010001698
REGENCE BLUE SHIELD OF ID
ID
01
—
39180
BLUE CROSS OF IDAHO
ID
Enumeration date
09/28/2006
Last updated
07/09/2007
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