Agrusa, Phillip C

Agrusa, Phillip C is an individual health care provider with primary practice located at 3520 E. Louise Dr , Meridian ID 83642. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Agrusa, Phillip C can be contacted via phone (208) 955-0350.

Contact Information

Primary practice address
3520 E. Louise Dr Meridian ID 83642
Phone: (208) 955-0350
Fax: (208) 955-0352
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X M7716 California

Profile Details

NPI number 1407826167
LBN Legal business name Agrusa, Phillip C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Jan 15th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407826167 NPPES
Idaho MEDICAID 805522900
Idaho Other 000010005656
Idaho MEDICAID 212843
Idaho Other J1742

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