Healthcare Provider Details

I. General information

NPI: 1538198098
Provider Name (Legal Business Name): HUGH G STERLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 W OVERLAND RD
BOISE ID
83709-3013
US

IV. Provider business mailing address

6000 W OVERLAND RD
BOISE ID
83709-3013
US

V. Phone/Fax

Practice location:
  • Phone: 208-336-7775
  • Fax: 208-515-3468
Mailing address:
  • Phone: 208-323-7588
  • Fax: 208-515-3468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM6211
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: