Organization
CARDIOVASCULAR CONSULTANTS OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN JOSEPH FONKEN MD (PRESIDENT)
(208) 377-1415
Entity
Organization
Contact information
Practice address
1070 N CURTIS RD, STE 125, BOISE, ID 83706-1238
(208) 377-1415
(208) 375-3451
Mailing address
1070 N CURTIS RD, STE 125, BOISE, ID 83706-1238
(208) 377-1415
(208) 375-3451
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
08/14/2006
Last updated
07/10/2008
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