NPI 1053574137 · live from the CMS NPI Registry
Robert James Douglas, md
Radiology, Diagnostic Radiology in Nampa, ID. National Provider Identifier 1053574137, active.
NPI record
| NPI | 1053574137 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 13865 Locust Ln, Nampa, ID 83686 |
| Practice phone | 208-989-4991 |
| Mailing address | 2510 Inagua Ave, N/A, Coconut Grove, FL 33133 |
| Enumerated | July 8, 2008 |
| Last updated | March 7, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | ME13225 (FL) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | ME13225 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.