IndividualActive
Michael Nieraeth, PA
NPI 1487904280 · Surgical Physician Assistant · Boise, ID
Provider details
- NPI number
- 1487904280
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- PA-993 (ID)
Practice location
8854 W Emerald St Ste 102
Boise, ID 83704
Phone: (208) 323-4747
Fax: (208) 323-4848
Mailing address
8854 W Emerald St Ste 102
Boise, ID 83704-4845
Registry dates
- Enumerated
- 2012-09-19
- Last updated
- 2019-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.