Individual
RAPHAEL SHAKUR KOMAKECH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBBCHB
Contact information
Practice address
4300 E FLAMINGO AVE, NAMPA, ID 83687-3138
(208) 463-5000
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7171372
ID
207R00000X
Internal Medicine Physician
MRM-2124
ID
Other
Enumeration date
03/30/2022
Last updated
03/13/2026
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