Wetherley, Graham K

Wetherley, Graham K is an individual health care provider with primary practice located at 4424 E Flamingo Ave Ste 300 , Nampa ID 83687-9306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Wetherley, Graham K can be contacted via phone (208) 302-0200.

Contact Information

Primary practice address
4424 E Flamingo Ave Ste 300 Nampa ID 83687-9306
Fax: (208) 302-0255
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X M5449 Idaho

Profile Details

NPI number 1821030586
LBN Legal business name Wetherley, Graham K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Jul 19th, 2022 - about 3 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 1821030586 NPPES
Idaho MEDICAID 002755800

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