OrganizationActive
Coeur D'Alene Surgical and Vein
NPI 1225368632 · Medical Specialty Clinic/Center · Coeur D Alene, ID
Provider details
- NPI number
- 1225368632
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Johnson, Managing Member(208) 664-4940
- License
- M-7963 (ID)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
608 Northwest Blvd
Suite 301
Coeur D Alene, ID 83814-2174
Phone: (208) 664-4940
Fax: (208) 664-5345
Approximate (ZIP-level) locationGet directions
Mailing address
608 Northwest Blvd
Coeur D Alene, ID 83814-2174
Registry dates
- Enumerated
- 2010-01-06
- Last updated
- 2013-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.