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General NPI Number Information
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NPI Number | 1750371894
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Entity Type | Organization
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Legal Business Name | DAVID N. SIM, M.D.,P.A.
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 6014 W EMERALD ST
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City | BOISE
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State | ID
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Zip | 83704-8855
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Country | US
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Telephone | 208-376-8666
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Fax | 208-376-9804
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Provider Business Mailing Address
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Address Line | 6014 W EMERALD ST
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City | BOISE
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State | ID
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Zip | 83704-8855
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Country | US
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Telephone | 208-376-8666
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Fax | 208-376-9804
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. DAVID NEIL SIM
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Credential | M.D.,P.A.
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Telephone | 208-376-8666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | M3561
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License Number State | ID
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