Individual
DR. CODI LYNN FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2347 E GALA ST, MERIDIAN, ID 83642-4881
(208) 323-3767
Mailing address
2347 E GALA ST, MERIDIAN, ID 83642-4881
(208) 323-3767
(206) 323-3768
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60776152
WA
207RP1001X
Pulmonary Disease Physician
M-15948
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/25/2015
Last updated
08/09/2021
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