Individual
MARY C HAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2971 E COPPER POINT DR, STE # 125, MERIDIAN, ID 83642-5101
(208) 893-5383
(208) 893-5386
Mailing address
2971 E COPPER POINT DR, STE # 125, MERIDIAN, ID 83642-5101
(208) 893-5383
(208) 893-5386
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M7753
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M7753
IDAHO STATE MEDICAL LICEN
ID
Enumeration date
05/31/2006
Last updated
03/07/2023
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