Healthcare Provider Details

I. General information

NPI: 1619974441
Provider Name (Legal Business Name): RICHARD G NEHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 N SECOND AVE STE 3
SANDPOINT ID
83864-1558
US

IV. Provider business mailing address

502 N SECOND AVE STE 3
SANDPOINT ID
83864-1558
US

V. Phone/Fax

Practice location:
  • Phone: 208-263-1421
  • Fax: 208-263-4430
Mailing address:
  • Phone: 208-263-1421
  • Fax: 208-263-4430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM4333
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: