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General NPI Number Information
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NPI Number | 1275347544
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Entity Type | Individual
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Provider Name | NOAH GESSAMAN
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Gender | Male
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 100 US-30
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City | FILER
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State | ID
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Zip | 83328
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Country | US
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Telephone | 208-326-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 21005 HIGHWAY 30
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City | FILER
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State | ID
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Zip | 83328-5544
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Country | US
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Telephone | 208-326-3131
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Fax |
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 250063
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License Number State | ID
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