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General NPI Number Information
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NPI Number | 1306780838
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Entity Type | Individual
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Provider Name | FREDRICK SHEMA
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Gender | Male
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 963 S ORCHARD ST
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City | BOISE
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State | ID
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Zip | 83705-1939
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Country | US
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Telephone | 208-473-0961
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Fax |
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Provider Business Mailing Address
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Address Line | 8452 W SHOOTING STAR DR
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City | BOISE
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State | ID
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Zip | 83709-7846
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Country | US
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Telephone | 208-473-0961
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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