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General NPI Number Information
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NPI Number | 1063548279
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Entity Type | Individual
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Provider Name | EDWARD ALLEN SAVALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 01/13/2016
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Provider Practice Location Address
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Address Line | 524 CLEVELAND BLVD STE. 110
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City | CALDWELL
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State | ID
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Zip | 83605-4076
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Country | US
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Telephone | 208-459-3630
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Fax | 208-459-3651
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Provider Business Mailing Address
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Address Line | 301 CLEVELAND BLVD STE. 110
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City | CALDWELL
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State | ID
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Zip | 83605-3625
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Country | US
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Telephone | 208-459-3630
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Fax | 208-459-3651
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | M8226
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License Number State | ID
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