IndividualActive
Nic Cordum, M.D.
NPI 1205803756 · Gastroenterology Physician · Boise, ID
Provider details
- NPI number
- 1205803756
- Entity type
- Individual
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- M6979 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
6259 W Emerald St
Boise, ID 83704-8731
Phone: (208) 489-1900
Fax: (208) 375-5286
Approximate (ZIP-level) locationGet directions
Mailing address
6259 W Emerald St
Boise, ID 83704-8731
Registry dates
- Enumerated
- 2006-03-03
- Last updated
- 2007-09-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.