Unknown Individual – Surgery Physician, NPI 1174575138
Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
West Emerald Street, Boise, Ada County, Idaho, 83704, United States
BOISE, ID 837044845
Phone: (208) 321-4790
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83704)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | ID | 38900 | Lymph node imaging during surgery | 14 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | ID | |
| - | ID | |
| Orthopedic Surgery | ID | |
| Physician Assistant | OR | |
| - | OR | |
| General Surgery | ID | |
| U R O L O G Y | IN | |
| General Surgery | ID | |
| General Surgery | ID |
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