Individual
STEVEN WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2850 OLYMPUS DR., POCATELLO, ID 83201
(208) 239-3815
(208) 239-3814
Mailing address
2850 OLYMPUS DR., POCATELLO, ID 83201
(208) 239-3815
(208) 239-3814
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01282
ID
207Q00000X
Family Medicine Physician
MRO-1740
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922592617
—
ID
Enumeration date
06/18/2018
Last updated
12/28/2023
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