Individual
DR. MATTHEW AARON WIDDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-17421
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2021
Last updated
08/06/2024
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