Individual
DANIEL ALLAN BRIDGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10583 W LAKE HAZEL RD, BOISE, ID 83709
(208) 302-5950
Mailing address
3340 E GOLDSTONE DR., MERIDIAN, ID 83642
(208) 302-5950
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101018222
MI
207P00000X
Emergency Medicine Physician
DO187470
OR
207P00000X
Emergency Medicine Physician
Primary
O-1144
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/01/2009
Last updated
01/06/2020
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