Individual
SHAUN J WESTERGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2001 S WOODRUFF AVE STE 9, IDAHO FALLS, ID 83404-6371
(208) 419-3002
(208) 656-5652
Mailing address
2001 S WOODRUFF AVE STE 9, IDAHO FALLS, ID 83404-6371
(208) 419-3002
(208) 656-5652
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-710
ID
363AM0700X
Medical Physician Assistant
PA710
ID
Other
Enumeration date
11/14/2007
Last updated
12/12/2023
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