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Individual

MR. DAVID M. SHUEY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1102 E LOCUST ST, EMMETT, ID 83617-2713
(208) 365-6004
(208) 365-3589
Mailing address
1102 E LOCUST ST, EMMETT, ID 83617-2713
(208) 365-6004
(208) 365-3589

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-430
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010158621
REGENCE BLUE SHIELD OF ID
ID
05
8074378
ID
01
PAD67
BLUE CROSS OF IDAHO
ID
Enumeration date
10/06/2006
Last updated
07/09/2007
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