Healthcare Provider Details

I. General information

NPI: 1598726960
Provider Name (Legal Business Name): CHRISTOPHER M ALESSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 N CURTIS RD STE 101
BOISE ID
83706-1348
US

IV. Provider business mailing address

1075 N CURTIS RD STE 101
BOISE ID
83706-1348
US

V. Phone/Fax

Practice location:
  • Phone: 208-302-5150
  • Fax: 208-302-5155
Mailing address:
  • Phone: 208-302-5150
  • Fax: 208-302-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD431690
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number11102
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberM-10811
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: