Wellformed AI

NPI 1679500557 · live from the CMS NPI Registry

Shane K Ball, M.D.

Radiology, Diagnostic Radiology in Boise, ID. National Provider Identifier 1679500557, active.

NPI record

NPI1679500557 Type 1 · individual
StatusActive
Primary specialtyRadiology, Diagnostic Radiology 2085R0202X
Practice location190 E Bannock St, Boise, ID 83712
Practice phone208-381-2094
Mailing addressPo Box 9696, Boise, ID 83707
EnumeratedJune 27, 2006
Last updatedJuly 8, 2007
Sole proprietorNo

Taxonomies and licenses

TaxonomyCodeLicense
Radiology, Diagnostic Radiology primary2085R0202XM9350 (ID)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.