Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 11273470-1205 | UT |
N | 207X00000X | Orthopaedic Surgeon | M-15187 | ID |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 11273470-1205 | UT |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | M-15187 | ID |
NPI | 1497172431 |
---|---|
Provider Name | Dr. Christopher Bryce Arena |
First Address | Coeur D Alene, ID 83814-6190 |
Second Address | Coeur D Alene, ID 83814-6190 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 02/11/2020 |