Individual
JAMES KATRIVESIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3277 E LOUISE DR STE 100, MERIDIAN, ID 83642-9360
(208) 706-7086
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
A122890
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
M-16126
ID
Other
Enumeration date
06/27/2011
Last updated
09/27/2022
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