St Clair Specialty Physicians
NPI #1063719292 in Boise, Idaho
Provider Information
- NPI Number
- 1063719292
- Entity Type
- Organization
- Organization Name
- St Clair Specialty Physicians
- Primary Specialty
- Internal Medicine - Nephrology
- Enumeration Date
- Feb 24, 2011
- Last Updated
- Feb 24, 2011
Practice Location
Authorized Official
- Name
- ROBERT PROVENZANO, MD
- Title
- PRESIDENT/PARTNER
- Phone
- (313) 886-8787
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Nephrology — Nephrology |
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