Individual
DR. MICHAEL A CODINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4424 E FLAMINGO AVE, SUITE 300, NAMPA, ID 83687-9306
(208) 302-0200
(208) 302-0255
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-0200
(208) 302-0255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
10982
NV
207RC0000X
Cardiovascular Disease Physician
Primary
M-10458
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100503714
—
NV
01
—
M-10458
IDAHO BOARD OF MEDICINE
ID
Enumeration date
05/27/2006
Last updated
11/15/2016
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