Healthcare Provider Details

I. General information

NPI: 1841245354
Provider Name (Legal Business Name): JOYCE ARLENE MAJURE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 ST. JOHNS WAY SUITE 11
LEWISTON ID
83501
US

IV. Provider business mailing address

307 ST. JOHNS WAY SUITE 11
LEWISTON ID
83501
US

V. Phone/Fax

Practice location:
  • Phone: 208-743-7612
  • Fax: 208-746-4802
Mailing address:
  • Phone: 208-743-7612
  • Fax: 208-746-4802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM5006
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD00023384
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: