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Michael Bertoch, CRNA

Nurse Anesthetist, Certified Registered in Idaho Falls, ID. Individual provider (NPI-1).

NPI number1609955129
StatusActive
Last updated in NPPESOct 31, 2007

Details

NPI
1609955129
Entity type
Individual (NPI-1)
Name
Michael Bertoch
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
Nov 3, 2006
Last updated
Oct 31, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified RegisteredRNA255IDYes

Practice location

2325 Coronado St
Idaho Falls, ID 83404-7407

Phone 208-557-2700

Mailing address

Po Box 3206
Idaho Falls, ID 83403-3206

Phone 208-523-4906 · Fax 208-523-2025

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