Individual
MARTIN R TUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 947-1947
(208) 947-1945
Mailing address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 947-1947
(208) 947-1945
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M8065
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805751800
—
ID
Enumeration date
05/16/2006
Last updated
01/28/2010
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