| Matthew R Sericati, M.d. Chartered | |
|
425 W Bannock St Boise ID 83702-6035 | |
| (208) 343-1702 | |
| (208) 342-7042 |
| Full Name | Matthew R Sericati, M.d. Chartered |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 425 W Bannock St, Boise, Idaho |
| Authorized Official Name and Position | Matthew R Sericati (PRESIDENT) |
| Authorized Official Contact | 2083431702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew R Sericati, M.d. Chartered 425 W Bannock St Boise ID 83702-6035 Ph: (208) 343-1702 | Matthew R Sericati, M.d. Chartered 425 W Bannock St Boise ID 83702-6035 Ph: (208) 343-1702 |
| NPI Number | 1760774483 |
|---|---|
| Provider Enumeration Date | 05/13/2011 |
| Last Update Date | 07/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760774483 | NPI | - | NPPES |
| 1194871871 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | M10669 (Idaho) | Primary |
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