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Individual

DR. GABRIELE EMMA TEERMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6048
(208) 529-7085
Mailing address
1820 E 17TH STREET, STE 230, IDAHO FALLS, ID 83404-6521
(208) 529-9779
(208) 542-2756

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35086120
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
M10187
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4010167583
REGENCE BLUE SHIELD OF IDAHO
ID
01
77343
BLUE CROSS OF IDAHO
ID
05
808087700
ID
Enumeration date
03/14/2006
Last updated
12/27/2012
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