Nathan J Hirsch, MD | |
450 W State St, Ste 100, Eagle, ID 83616 | |
(208) 939-1035 | |
Not Available |
Full Name | Nathan J Hirsch |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 450 W State St, Eagle, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669556643 | NPI | - | NPPES |
00G845790 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | G84579 (California) | Secondary |
208000000X | Pediatrics | M11639 (Idaho) | Primary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
---|---|
Nathan J Hirsch, MD 190 E Bannock St, Boise, ID 83712 Ph: (208) 381-2222 | Nathan J Hirsch, MD 450 W State St, Ste 100, Eagle, ID 83616 Ph: (208) 939-1035 |
Noreen A. Womack, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 450 W State St, Suite 100, Eagle, ID 83616 Phone: 208-939-1035 Fax: 208-939-8970 | |
Mr. Nicholas J Lewis, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 3101 E State St Ste And2107, Eagle, ID 83616 Phone: 208-473-3500 Fax: 208-473-3510 | |
Mrs. Amanda Beth Wartner Stinger, M.D., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 450 W State St, Eagle, ID 83616 Phone: 208-939-1035 | |
Dr. Daniela Grigore, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3217 W Bavaria Street, Eagle, ID 83616 Phone: 208-302-6200 Fax: 208-302-6255 | |
Hailey N. Baisch, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 450 W State St Ste 100, Eagle, ID 83616 Phone: 208-939-1035 | |
Dr. Alan Paul Miller, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 125 Stierman Way, Eagle, ID 83616 Phone: 208-939-4880 Fax: 208-939-5003 |