Individual
ANDREA D AXTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
323 E RIVERSIDE DR STE 224, EAGLE, ID 83616-6865
(208) 302-6000
(208) 302-6055
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL17364
OR
207R00000X
Internal Medicine Physician
Primary
M11047
ID
Other
Enumeration date
07/30/2007
Last updated
02/18/2025
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