Individual
MR. DEWEY MICHAEL DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
333 NORTH 18TH, BLDG A, POCATELLO, ID 83201
(208) 233-8880
(208) 232-1950
Mailing address
PO BOX 4107, POCATELLO, ID 83205-4107
(208) 233-8880
(208) 232-1950
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA872A
ID
Other
Enumeration date
07/30/2013
Last updated
01/15/2020
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