| Boundary Medicine & Wellness, Llc | |
|
7820 Old Highway Two Loop Moyie Springs ID 83845-5187 | |
| (208) 304-6401 | |
| Not Available |
| Full Name | Boundary Medicine & Wellness, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7820 Old Highway Two Loop, Moyie Springs, Idaho |
| Authorized Official Name and Position | Christopher Maynard Bryant (OWNER) |
| Authorized Official Contact | 2083046401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boundary Medicine & Wellness, Llc 7820 Old Highway Two Loop Moyie Springs ID 83845-5187 Ph: (208) 304-6401 | Boundary Medicine & Wellness, Llc 7820 Old Highway Two Loop Moyie Springs ID 83845-5187 Ph: (208) 304-6401 |
| NPI Number | 1437866654 |
|---|---|
| Provider Enumeration Date | 10/28/2022 |
| Last Update Date | 01/11/2023 |
| Medicare PECOS PAC ID | 1153792775 |
|---|---|
| Medicare Enrollment ID | O20230118002692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437866654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Christopher M Bryant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740633536 PECOS PAC ID: 4789978446 Enrollment ID: I20220302002773 |
North Idaho Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1589 Perkins Lake Rd, Moyie Springs, ID 83845 Phone: 760-382-4281 |