Mortensen, Wayne Marcus

Mortensen, Wayne Marcus is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Mortensen, Wayne Marcus can be contacted via phone (208) 381-2094.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-2094
Fax: (208) 381-1791
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 0116019824 Virginia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 7152301-1205 Utah
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 7152301-8905 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M12065 Idaho

Profile Details

NPI number 1780878314
LBN Legal business name Mortensen, Wayne Marcus
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2007
Last updated Jan 10th, 2018 - about 7 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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