Kronholm, Stephen K

Kronholm, Stephen K is an individual health care provider with primary practice located at 2315 8Th St , Lewiston ID 83501-7301. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Kronholm, Stephen K can be contacted via phone (208) 746-1383.

Contact Information

Primary practice address
2315 8Th St Lewiston ID 83501-7301
Phone: (208) 746-1383
Fax: (208) 746-6348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X M-6391 Idaho
Allopathic & Osteopathic Physicians / Urology 208800000X M-6391 Idaho

Profile Details

NPI number 1487630968
LBN Legal business name Kronholm, Stephen K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Oct 14th, 2015 - about 10 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 1487630968 NPPES
Idaho Other 000010000609 REGENCE
Idaho Other 20006147 REGENCE
Idaho MEDICAID 003782100 REGENCE
Idaho Other 4117-8 REGENCE

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