Doctor Name: | MICHAEL K PARENT |
NPI Number: | 1578552139 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | M4475 |
Business Practice Address: | 1630 23rd Ave Suite 701 Lewiston, ID - 835016350 |
Business Phone Number: | 2087433998 |
Business Fax Number: | 2087464879 |
Mailing Address: | 1630 23rd Ave, Suite 701 LEWISTON |
State: | ID |
Postal Code: | 835016350 |
Phone Number: | 2087433998 |
Fax Number: | 2087464879 |
NPI Enumeration Date: | 10/17/2005 |
NPI Last Update Date: | 05/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | M4475 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |