| Momentum Medical Group Of Idaho Llc | |
|
8854 W Emerald St Ste 275 Boise ID 83704-4860 | |
| (208) 375-3201 | |
| Not Available |
| Full Name | Momentum Medical Group Of Idaho Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8854 W Emerald St Ste 275, Boise, Idaho |
| Authorized Official Name and Position | Heather Beard (BILLING SERVICE) |
| Authorized Official Contact | 2088800883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Momentum Medical Group Of Idaho Llc 8854 W Emerald St Ste 140 Boise ID 83704-4845 Ph: () - | Momentum Medical Group Of Idaho Llc 8854 W Emerald St Ste 275 Boise ID 83704-4860 Ph: (208) 375-3201 |
| NPI Number | 1417737594 |
|---|---|
| Provider Enumeration Date | 10/04/2023 |
| Last Update Date | 01/10/2024 |
| Medicare PECOS PAC ID | 2668824608 |
|---|---|
| Medicare Enrollment ID | O20240116001570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417737594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Scott N Schwendiman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538110234 PECOS PAC ID: 0941368344 Enrollment ID: I20081208000606 |
| Provider Name | Michael M Dee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053302182 PECOS PAC ID: 4981700143 Enrollment ID: I20100315000934 |
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