Healthcare Provider Details

I. General information

NPI: 1164574372
Provider Name (Legal Business Name): FRANK ALAN GERMANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7267 POTOMAC DR
BOISE ID
83704-9150
US

IV. Provider business mailing address

3210 E CHINDEN BLVD #115-523
EAGLE ID
83616-6763
US

V. Phone/Fax

Practice location:
  • Phone: 208-321-9550
  • Fax: 208-323-9070
Mailing address:
  • Phone: 208-321-9550
  • Fax: 208-323-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberM6022
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: