Individual
DANIEL DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5985 W STATE ST, BOISE, ID 83703-3039
(208) 853-0071
Mailing address
5985 W STATE ST, BOISE, ID 83703-3039
(208) 853-0071
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M7188
ID
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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