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Individual

DAVID H SIMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1425 W RIVER ST, BOISE, ID 83702-6861
(208) 342-2087
(208) 336-1954
Mailing address
1605 S KIMBALL AVE, SUITE 205, CALDWELL, ID 83605-4548
(208) 455-1400
(208) 455-1449

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA267
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010136818
BLUE SHIELD
ID
01
A2286
BLUE CROSS
ID
Enumeration date
08/20/2006
Last updated
07/09/2007
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