Diabetes And Internal Medicine
Internal Medicine in Pocatello, ID. Organization (NPI-2).
NPI number1225257652
StatusActive
Last updated in NPPESFeb 17, 2010
Details
- NPI
- 1225257652
- Entity type
- Organization (NPI-2)
- Legal business name
- Diabetes And Internal Medicine
- Organization subpart
- No
- Enumeration date
- Apr 24, 2007
- Last updated
- Feb 17, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | ID | Yes |
Practice location
2302 E. Terry StreetPocatello, ID 83201
Phone 208-236-1600
Mailing address
Po Box 335Pocatello, ID 83204-0335
Phone 208-236-1600 · Fax 208-236-6695
Authorized official
Sherwin D'Souza
President
2082361600
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