Fairfax, Walter Raymond

Fairfax, Walter Raymond is an individual health care provider with primary practice located at 2003 Kootenai Health Way , Coeur D Alene ID 83814-6051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as his primary health care specialty. Fairfax, Walter Raymond can be contacted via phone (208) 625-4000.

Contact Information

Primary practice address
2003 Kootenai Health Way Coeur D Alene ID 83814-6051
Phone: (208) 625-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X M11477 Idaho

Profile Details

NPI number 1124170170
LBN Legal business name Fairfax, Walter Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Apr 16th, 2024 - about last year

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 1124170170 NPPES
Montana Other 000096870 BCBS PIN
Montana Other 0011135 BCBS PIN
Montana Other 105079600 BCBS PIN

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