Individual
MARK A SPELICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7979 W RIFLEMAN ST, BOISE, ID 83704-9066
(208) 855-2410
(208) 855-0157
Mailing address
7979 W. RIFLEMAN, BOISE, ID 83704
(208) 855-2410
(208) 855-0157
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M9278
ID
207X00000X
Orthopaedic Surgery Physician
MD25792
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151179
REG
—
01
—
74880
BX
—
05
—
807210200
—
ID
Enumeration date
08/09/2006
Last updated
04/01/2013
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