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Dr. Heather Fowler Cumbo, MD

Psychiatry & Neurology, Psychiatry in Lewiston, ID. Individual provider (NPI-1).

NPI number1063668077
StatusActive
Last updated in NPPESSep 30, 2020

Details

NPI
1063668077
Entity type
Individual (NPI-1)
Name
Dr. Heather Fowler Cumbo
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Aug 10, 2008
Certification date
Sep 30, 2020
Last updated
Sep 30, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, PsychiatryME121892FLYes
207R00000X Internal Medicine149697NC
2084P0800X Psychiatry & Neurology, PsychiatryM-13872ID

Practice location

415 6th St
Lewiston, ID 83501-2434

Phone 208-750-7445

Mailing address

2280 E 25th St
Idaho Falls, ID 83404-7542

Phone 208-227-2100

Other practice locations

2280 E 25th St
Idaho Falls, ID 83404-7542

Phone 208-227-2100

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