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Individual

THOMAS J GELWIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-3813
(208) 785-3818
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-8290
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010141114
BSID
ID
01
52332
BCID
ID
05
Z2575
UT
Enumeration date
06/07/2006
Last updated
02/27/2008
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