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Search › Idaho › 207RE0101X

Theodore Roosevelt, M.D

NPI 1699754697 · on the registry since 2006 · sole proprietor

Practice

Address
13909 W Wainwright Dr
Boise, ID 83713
Phone
(208) 389-2213
Fax
(208) 389-4659
Organisation at this address
Aspire Wellness Pc
Alliance Physical Medicine
Idaho Diabetes And Endocrine Associates, Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address
3

Registry record

Primary taxonomy
207RE0101X
207RE0101X
Also registered as
207R00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-05-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho