Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD 066388L | PA |
N | 111NI0900X | Internist | MD 066388L | PA |
N | 207RG0300X | Geriatric Medicine | MD 066388L | PA |
N | 207RR0500X | Rheumatology | MD066388L | PA |
NPI | 1164434635 |
---|---|
Provider Name | Dr. Desmond Anim-Appiah |
First Address | Boise, ID 83702-4501 |
Second Address | Boise, ID 83702-4501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |