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NPI Code Detail

MEDICARE: AURORA HORSTKAMP MD

MEDICARE: AURORA HORSTKAMP MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00033290WA
2207Q00000XFamily Medicine PhysicianM-16585ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255304499
Entity Type Code : Individual
Provider Name (Legal Business Name) : AURORA HORSTKAMP MD
Provider Business Mailing Address
First Line : PO BOX 367
Second Line :
City : LAPWAI
State : ID
Zip : 83540-0367
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : NE 1125 WASHINGTON ST
Second Line : WASHINGTON STATE UNIVERSITY
City : PULLMAN
State : WA
Zip : 99164-0001
Country : US
Telephone Number : 509-335-3575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 06/17/2022

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