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NPI Code Detail

MEDICARE: MISA PERRON-BURDICK MD

MEDICARE: MISA PERRON-BURDICK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianA112385CA
2207V00000XObstetrics & Gynecology PhysicianM-16679ID

General Provider Information

NPI Number : 1386952117
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISA PERRON-BURDICK MD
Provider Business Mailing Address
First Line : 190 E BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83712-6241
Country : US
Telephone Number : 208-381-8752
Fax Number :
Provider Business Practice Location Address
First Line : 520 S EAGLE RD STE 3209
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-6356
Country : US
Telephone Number : 208-706-3220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2010
Last Update Date : 04/28/2026

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Directions to “ MISA PERRON-BURDICK MD” Practice Location

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