Individual
MR. BRET A DIRKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 W IRONWOOD DR SUITE 300, COEUR DALENE, ID 83814
(208) 667-1376
(208) 292-0873
Mailing address
850 W IRONWOOD DR SUITE 300, COEUR DALENE, ID 83814
(208) 667-1376
(208) 292-0873
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M6482
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376455
MDC GROUP
—
05
—
2741300
—
ID
Enumeration date
09/15/2006
Last updated
02/27/2008
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