Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | M-4835 | ID |
N | 207RP1001X | Pulmonary Disease | M-4835 | ID |
NPI | 1023195708 |
---|---|
Provider Name | Dr. Nirmal B. Charan |
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 | 01/11/2006 |
Last Update Date | 14/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
808191000 | (05) | ID |