OrganizationActive
Matthew R Sericati, M.D. Chartered
NPI 1760774483 · Gastroenterology Physician · Boise, ID
Provider details
- NPI number
- 1760774483
- Entity type
- Organization
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Matthew Sericati, President(208) 343-1702
- License
- M10669 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
425 W Bannock St
Boise, ID 83702-6035
Phone: (208) 343-1702
Fax: (208) 342-7042
Approximate (ZIP-level) locationGet directions
Mailing address
425 W Bannock St
Boise, ID 83702-6035
Additional practice locations (3)
- 2235 E Gala StMeridian, ID 83642-8026Phone: (208) 877-3724Fax: (208) 877-1682
- 9850 St Lukes DrNampa, ID 83687-7912Phone: (208) 343-6458Fax: (208) 342-7042
- 1200 Garrity BlvdNampa, ID 83687-3402Phone: (208) 343-1702
Registry dates
- Enumerated
- 2011-05-13
- Last updated
- 2019-07-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.