Medical Center for Children & Adolescents, PA

NPI #1073528998 in Idaho Falls, Idaho

Provider Information

NPI Number: 1073528998
Entity Type: Organization
Organization Name: Medical Center for Children & Adolescents, PA
Primary Specialty: Pediatrics
Enumeration Date: Jul 29, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 3430 WASHINGTON PKWY
City: Idaho Falls
State: Idaho
ZIP Code: 83404-7579
Phone: (208) 523-3060

Authorized Official

Name: DR. MICHAEL JUDE PANKAU, M.D.
Title: PRESIDENT
Phone: (208) 523-3060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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