Individual
STEPHEN R BIENZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 288-4970
(208) 288-4990
Mailing address
217 W GEORGIA AVE, SUITE 115, NAMPA, ID 83686-6811
(208) 463-3000
(208) 463-3034
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
1654451205
UT
207RR0500X
Rheumatology Physician
Primary
M4472
ID
207RR0500X
Rheumatology Physician
MD00036459
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004875
BLUE SHIELD
ID
01
—
000010004876
BLUE SHIELD
ID
01
—
38737
BLUE CROSS
ID
01
—
J3979
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
07/08/2007
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