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Individual

KEVIN J CHICOINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
315 E ELM ST, CALDWELL, ID 83605-4857
(208) 459-7415
(208) 453-3200
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
63004
MT
207Q00000X
Family Medicine Physician
Primary
M8223
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806006100
ID
Enumeration date
06/12/2006
Last updated
03/20/2018
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