Individual
SAMUAL BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 E JEFFERSON, STE 101, BOISE, ID 83712
(208) 336-4141
(208) 336-4035
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 322-1680
(208) 322-1695
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M9570
ID
207RC0000X
Cardiovascular Disease Physician
M9570
IL
Other
Enumeration date
06/15/2006
Last updated
09/11/2012
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