Mcintosh, Daniel Brodie

Mcintosh, Daniel Brodie is an individual health care provider with primary practice located at 307 Saint Johns Way Ste #9, Lewiston ID 83501-2435. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mcintosh, Daniel Brodie can be contacted via phone (208) 746-7055.

Contact Information

Primary practice address
307 Saint Johns Way Ste #9 Lewiston ID 83501-2435
Phone: (208) 746-7055
Fax: (208) 746-4899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X M5406 Idaho

Profile Details

NPI number 1801831151
LBN Legal business name Mcintosh, Daniel Brodie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Jul 8th, 2007 - about 17 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 1801831151 NPPES
Idaho Other 000010005765 REGENCE
Idaho Other 54064 REGENCE
Idaho MEDICAID 000826400 REGENCE

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