| Northwest Integrative Family Med | |
|
1110 Polston Ave Ste 1 Post Falls ID 83854 | |
| (208) 773-1311 | |
| (208) 773-1644 |
| Full Name | Northwest Integrative Family Med |
|---|---|
| Speciality | Family Medicine |
| Location | 1110 Polston Ave, Post Falls, Idaho |
| Authorized Official Name and Position | Michael L. Oglesbay (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2087731311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Integrative Family Med 3773 W 5th Ave Ste 301 Post Falls ID 83854-6728 Ph: (208) 773-1311 | Northwest Integrative Family Med 1110 Polston Ave Ste 1 Post Falls ID 83854 Ph: (208) 773-1311 |
| NPI Number | 1548200181 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 05/02/2019 |
| Medicare PECOS PAC ID | 8729343330 |
|---|---|
| Medicare Enrollment ID | O20180601001315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548200181 | NPI | - | NPPES |
| 806345800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M8602 (Idaho) | Primary |
| Provider Name | Michael Lee Oglesbay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659476844 PECOS PAC ID: 5597651844 Enrollment ID: I20180629000504 |
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