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Individual

DR. RALPH P CAMPANALE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
180 W FIRST STREET SUITE 301, KETCHUM, ID 83340
(208) 726-3707
(208) 726-4817
Mailing address
PO BOX 777, COEUR D ALENE, ID 83816-0777
(208) 772-5882
(208) 762-7543

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M4961
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010000420
REGENCE BLUE SHIELD
ID
05
002699100
ID
01
020024438
RAILROAD MEDICARE
ID
01
D3513
BLUE CROSS OF ID
ID
Enumeration date
04/11/2006
Last updated
07/08/2007
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