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General NPI Number Information
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NPI Number | 1528845294
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Entity Type | Organization
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Legal Business Name | BBC SILVERSTONE LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 1144 S SILVERSTONE WAY STE 160
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City | MERIDIAN
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State | ID
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Zip | 83642-8854
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Country | US
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Telephone | 248-515-9101
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Fax | 208-464-9734
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Provider Business Mailing Address
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Address Line | PO BOX 4886
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City | BOISE
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State | ID
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Zip | 83711-4886
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD/PARTNER
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Name | BARBARA ANN WHITE
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Credential | MD
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Telephone | 208-214-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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