Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | M-15204 | ID |
NPI | 1003131509 |
---|---|
Provider Name | Dr. Andrew Lee Mesher |
First Address | Boise, ID 83702-6132 |
Second Address | Boise, ID 83702-6132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 06/06/2020 |