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General NPI Number Information
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NPI Number | 1215936638
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Entity Type | Organization
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Legal Business Name | NORTH IDAHO DERMATOLOGY, INC.
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 2199 N MERRITT CREEK LOOP
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4949
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Country | US
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Telephone | 208-665-7546
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Fax | 208-667-4607
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Provider Business Mailing Address
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Address Line | 2199 N MERRITT CREEK LOOP
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4949
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Country | US
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Telephone | 208-665-7546
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Fax | 208-667-4607
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN C RINGGER
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Credential | MD
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Telephone | 208-665-7546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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