Tubach, Shana L

Tubach, Shana L is an individual health care provider with primary practice located at 1072 N Liberty St Suite 203, Boise ID 83704-8708. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Tubach, Shana L can be contacted via phone (208) 302-5800.

Contact Information

Primary practice address
1072 N Liberty St Suite 203 Boise ID 83704-8708
Phone: (208) 302-5800
Fax: (208) 302-5855
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M8077 Idaho
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M-8077 Idaho

Profile Details

NPI number 1205879483
LBN Legal business name Tubach, Shana L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Nov 10th, 2016 - about 9 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 1205879483 NPPES
Idaho MEDICAID 805784500

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