Organization
IDAGEM SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN KRAWTZ (CEO)
(208) 283-6678
Entity
Organization
Contact information
Practice address
1533 N MILWAUKEE ST, STE 321, BOISE, ID 83704-8471
(208) 283-6678
Mailing address
1533 N MILWAUKEE ST, STE 321, BOISE, ID 83704-8471
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
M9083
ID
Other
Enumeration date
09/28/2009
Last updated
10/27/2010
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