| Eagle Internal Medicine, Pllc | |
|
1025 S Bridge Way Pl Suite 100 Eagle ID 83616-6834 | |
| (208) 938-0090 | |
| Not Available |
| Full Name | Eagle Internal Medicine, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1025 S Bridge Way Pl, Eagle, Idaho |
| Authorized Official Name and Position | Michael A Patmas (PRESIDENT) |
| Authorized Official Contact | 2089380090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Internal Medicine, Pllc 1025 S. Bridgeway Pl. Suite 100 Eagle ID 83616 Ph: (208) 938-0090 | Eagle Internal Medicine, Pllc 1025 S Bridge Way Pl Suite 100 Eagle ID 83616-6834 Ph: (208) 938-0090 |
| NPI Number | 1609004597 |
|---|---|
| Provider Enumeration Date | 06/30/2009 |
| Last Update Date | 06/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609004597 | NPI | - | NPPES |
| C55688 | Other | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M10058 (Idaho) | Primary |
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