Snake River Pediatrics, PC

NPI #1871952267 in Fruitland, Idaho

Provider Information

NPI Number: 1871952267
Entity Type: Organization
Organization Name: Snake River Pediatrics, PC
Primary Specialty: Pediatrics
Enumeration Date: Feb 15, 2016
Last Updated: Feb 1, 2024

Practice Location

Address: 1100 NW 12TH ST
City: Fruitland
State: Idaho
ZIP Code: 83619-5040
Phone: (208) 452-6556

Authorized Official

Name: MATTHEW JOSEPH BERRIA, PHD, PA-C
Title: PRESIDENT
Phone: (208) 740-4518

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner - Pediatrics — Pediatrics	363LP0200X
Pediatrics	208000000X	Primary

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