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General NPI Number Information
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NPI Number | 1407799380
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Entity Type | Organization
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Legal Business Name | ANEW MED, PLLC
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 3501 W ELDER ST STE 102
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City | BOISE
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State | ID
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Zip | 83705-4986
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Country | US
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Telephone | 503-210-8898
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N HOWARD ST STE R
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City | SPOKANE
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State | WA
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Zip | 99201-0508
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Country | US
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Telephone | 503-210-8898
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JONATHAN HODOR
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Credential | DO, MS, ACOOG
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Telephone | 503-210-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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