Individual
LINDA S MICHALSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 W IRONWOOD DR, SUITE 110, COEUR D ALENE, ID 83814-2656
(208) 666-3200
(208) 666-3217
Mailing address
PO BOX 1829, COEUR D ALENE, ID 83816-1829
(208) 666-3200
(208) 666-3397
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M7269
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139160
CIGNA MEDICARE - RANI
ID
01
—
300086415
RR MEDICARE
ID
01
—
72694
BC ID - RANI
ID
05
—
805216100
—
ID
05
—
8237687
—
WA
01
—
B1253
BC ID - PF
ID
01
—
DM776
BC ID - CDA
ID
01
—
P00104434
RR MEDICARE - RANI
ID
Enumeration date
08/11/2005
Last updated
02/24/2012
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