NPI 1184255754

Idaho Modern Medicine - PLLC

Organisation Family Medicine Physician Pocatello, ID

Practice location

Address: 1000 Pocatello Creek Rd STE E10, Pocatello, ID 83201-2953
Phone: (208) 317-5371

Authorised official

Name: Michael a Anderson
Title: Physician / Owner
Phone: (208) 648-4789

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Idaho →

Registry record

NPI: 1184255754
Entity type: Organization
NPI issued: 31 Jan 2020
Record last updated: 5 Feb 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.