Individual
DR. MARK EDWARD BARADZIEJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1136
Mailing address
1735 ROANOKE DR, BOISE, ID 83712-7524
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6801
ID
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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