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Organization

NORTH IDAHO NEPHROLOGY ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAUN K. JOSHI M.D. (OWNER)
(208) 762-7760
Entity
Organization

Contact information

Practice address
1986 W HAYDEN AVE STE C, HAYDEN, ID 83835-7412
(208) 762-7760
(208) 762-7740
Mailing address
1986 W HAYDEN AVE STE C, HAYDEN, ID 83835-7412
(208) 762-7760
(208) 762-7740

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010166370
REGENCE BLUE SHIELD
ID
05
808003600
ID
05
8239220
WA
01
8N389
BLUE CROSS OF IDAHO
ID
Enumeration date
12/24/2007
Last updated
07/15/2021
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