NPI 1528704863

Integrated Dermatology of Boise, LLC

Organisation Dermatology Physician Meridian, ID

Practice location

Address: 3277 E Louise Dr STE 360, Meridian, ID 83642-9359
Phone: (208) 900-3376
Fax: (986) 210-1370
Mailing address: 4700 Exchange CT STE 110, Boca Raton, FL 33431-4450

Authorised official

Name: Mary Ellen J Luchetti
Title: Authorized Group Official
Phone: (208) 900-3376

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Idaho →

Registry record

NPI: 1528704863
Entity type: Organization
NPI issued: 10 May 2022
Record last updated: 5 Dec 2022

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.