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NPI 1184865883 · Preventive Medicine/Occupational Environmental Medicine Physician · Boise, ID
Provider details
- NPI number
- 1184865883
- Entity type
- Organization
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Ralph Sutherlin, Owner/Physician
- License
- 0-264 (ID)
Practice location
3224 N Maple Grove Rd
Boise, ID 83704-4214
Phone: (208) 495-3688
Fax: (208) 475-4924
Mailing address
3224 N Maple Grove Rd
Boise, ID 83704-4214
Registry dates
- Enumerated
- 2009-03-10
- Last updated
- 2009-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.