Healthcare Provider Details

I. General information

NPI: 1053481366
Provider Name (Legal Business Name): SUZANNE MICHELLE RING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N ROBBINS RD STE 100
BOISE ID
83702-4566
US

IV. Provider business mailing address

600 N ROBBINS RD STE 401
BOISE ID
83702-4566
US

V. Phone/Fax

Practice location:
  • Phone: 208-383-0201
  • Fax: 208-489-4300
Mailing address:
  • Phone: 208-383-0201
  • Fax: 208-489-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberO-0405
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: