IndividualActive
Theodore Roosevelt, M.D.
NPI 1699754697 · Endocrinology, Diabetes & Metabolism Physician · Boise, ID
Provider details
- NPI number
- 1699754697
- Entity type
- Individual
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- M6142 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
13909 W Wainwright Dr
Boise, ID 83713-1969
Phone: (208) 389-2213
Fax: (208) 389-4659
Approximate (ZIP-level) locationGet directions
Mailing address
13909 W Wainwright Dr
Boise, ID 83713-1969
Registry dates
- Enumerated
- 2006-01-10
- Last updated
- 2018-05-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.