Dr. Praveen Bere, MD
Hospitalist in Boise, ID. Individual provider (NPI-1).
NPI number1265710305
StatusActive
Last updated in NPPESNov 5, 2024
Details
- NPI
- 1265710305
- Entity type
- Individual (NPI-1)
- Name
- Dr. Praveen Bere
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 22, 2011
- Certification date
- Nov 5, 2024
- Last updated
- Nov 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | 5561374 | ID | Yes |
| 207R00000X | Internal Medicine | BP10040139 | TX | |
| 208M00000X | Hospitalist | MD2014-0084 | NM |
Practice location
190 E Bannock StBoise, ID 83712-6241
Phone 208-381-5015 · Fax 208-381-1873
Mailing address
190 E Bannock StBoise, ID 83712-6241
Other practice locations
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Las Cruces, NM 88011-5069
Phone 575-521-5457 · Fax 575-521-5471
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