Individual
MATTHEW MORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 344-7799
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
5101021036
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
O-1265
ID
Other
Enumeration date
05/14/2014
Last updated
08/07/2019
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