Fonken, Steven J
Fonken, Steven J is an individual health care provider with primary practice located at 500 W. Fort St # 111, Boise ID 83702. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Fonken, Steven J can be contacted via phone (208) 422-1000.Contact Information
Primary practice address
500 W. Fort St # 111
Boise ID 83702
Phone: (208) 422-1000
Fax: (208) 422-1319
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | M-7934 | Idaho |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | M-7934 | Idaho |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | M-7934 | Idaho |
Profile Details
| NPI number | 1063437630 |
|---|---|
| LBN Legal business name | Fonken, Steven J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Mar 1st, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063437630 | NPPES |
| Other | 000010027675 | REGENCE BLUE SHIELD OF ID | |
| MEDICAID | 805658400 | REGENCE BLUE SHIELD OF ID | |
| Other | 59923 | REGENCE BLUE SHIELD OF ID |
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