Healthcare Provider Details

I. General information

NPI: 1780719898
Provider Name (Legal Business Name): SALTZER MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 E FLAMINGO AVE
NAMPA ID
83687-9203
US

IV. Provider business mailing address

217 W GEORGIA AVE STE 115
NAMPA ID
83686-6816
US

V. Phone/Fax

Practice location:
  • Phone: 208-288-4970
  • Fax: 208-288-4990
Mailing address:
  • Phone: 208-463-3000
  • Fax: 208-463-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM E SAVAGE
Title or Position: CEO
Credential: CEO
Phone: 208-463-3000