Dr Edward Gerard Detar, MD | |
700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814-4404 | |
(208) 625-5200 | |
(208) 625-5201 |
Full Name | Dr Edward Gerard Detar |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 26 Years |
Location | 700 W Ironwood Dr Ste 341, Coeur D Alene, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194706465 | NPI | - | NPPES |
P00448097 | Other | ID | RR MEDICARE |
1124619 | Medicaid | WA | |
807836200 | Medicaid | ID | |
77068 | Other | ID | BC ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | M-9855 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Kootenai Health | Coeur d'alene, ID | Hospital |
Clearwater Valley Hospital & Clinics | Orofino, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Kootenai Health Inc | 1355792276 | 330 |
Entity Name | Clearwater Valley Hospital & Clinics |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073551396 PECOS PAC ID: 0547173346 Enrollment ID: O20031117000264 |
Entity Name | Kootenai Health, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230 |
Entity Name | Kootenai Health Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252 |
Mailing Address | Practice Location Address |
---|---|
Dr Edward Gerard Detar, MD 700 W Ironwood Dr, Suite 304, Coeur D Alene, ID 83814-2656 Ph: (208) 625-5200 | Dr Edward Gerard Detar, MD 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814-4404 Ph: (208) 625-5200 |
Dr. Lucas Aaron Anderson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-4000 | |
Michael Thomas May, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814 Phone: 208-625-5200 Fax: 208-625-5201 | |
Dr. Robert Sumner West, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3621 W Fairway Dr, Coeur D Alene, ID 83815 Phone: 208-765-0714 Fax: 209-664-8238 | |
Dr. Marcus Jewell Torgenson, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 341, Coeur D Alene, ID 83814 Phone: 208-625-5200 Fax: 208-625-5201 | |
Benjamin Mandel, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5085 Fax: 208-625-5731 | |
Matthew Lauritz Low, MD Surgery Medicare: Medicare Enrolled Practice Location: 700 W Ironwood Dr Ste 350, Coeur D Alene, ID 83814 Phone: 208-625-5222 Fax: 208-625-5223 |