Individual
DR. MARTHA MARIE PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2782
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
M-16672
ID
2080P0207X
Pediatric Hematology & Oncology Physician
M1370
TX
390200000X
Student in an Organized Health Care Education/Training Program
M1370
TX
Other
Enumeration date
07/03/2007
Last updated
06/16/2022
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