Unknown Individual – Plastic Surgery Physician, NPI 1841307147
Plastic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2771, West Conifer Drive, Redwood Creek, Eagle, Ada County, Idaho, 83616, United States
EAGLE, ID 836164662
Phone: (208) 939-0998
Fax: (208) 939-8185
Type: Mailing
300, North Liberty Street, Boise Junction, Boise, Ada County, Idaho, 83704, United States
BOISE, ID 837048729
Phone: (208) 367-6901
Fax: (208) 367-6904
Type: Location
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
Source: CMS public data · Not endorsed by CMS ·
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83616)
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