Dattilo, Ginger L.

Dattilo, Ginger L. is an individual health care provider with primary practice located at 111 Ridgview Dr. , Bellevue ID 83313-0828. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Dattilo, Ginger L. can be contacted via phone (720) 301-2055.

Contact Information

Primary practice address
111 Ridgview Dr. Bellevue ID 83313-0828
Phone: (720) 301-2055
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD20663 Oregon
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 43963 Colorado

Profile Details

NPI number 1639240864
LBN Legal business name Dattilo, Ginger L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2006
Last updated May 15th, 2015 - about 9 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 1639240864 NPPES
Oregon MEDICAID 272459

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