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Individual

JOHN D CRITES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2993 N COLE RD, BOISE, ID 83704-5977
(208) 378-0400
(208) 378-7529
Mailing address
2993 N COLE RD, BOISE, ID 83704-5977
(208) 378-0400
(208) 378-7529

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8620
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806407900
ID
01
P00317456
RR MEDICARE
Enumeration date
06/03/2006
Last updated
08/04/2008
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