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Individual

DR. MATTHEW R MACHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
323 E RIVERSIDE DR STE 220, EAGLE, ID 83616-5246
(208) 343-5600
(208) 779-2898
Mailing address
PO BOX 2045, EAGLE, ID 83616-9110
(208) 343-5600
(208) 779-2898

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6834
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010001037
REGENCE BS BOI
ID
01
000010144925
REGENBE BS MTN HOME
ID
01
000010149831
REGENCE BS EMMETT
ID
05
002279400
ID
01
020030135
TRICARE
ID
01
70334
BLUE CROSS OF IDAHO BOIS
ID
01
B3861
BLUE CROSS OF ID EMMETT
ID
01
B3879
BC OF IDAHO MTN HOME
ID
Enumeration date
08/11/2006
Last updated
09/30/2024
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