IndividualActive
Evan Melville, DO
NPI 1942867148 · Pediatric Sports Medicine Physician · Boise, ID
Provider details
- NPI number
- 1942867148
- Entity type
- Individual
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- O-1882 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2619 W Fairview Ave
Boise, ID 83702-6722
Phone: (208) 706-9311
Fax: (208) 489-4300
Approximate (ZIP-level) locationGet directions
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Registry dates
- Enumerated
- 2019-05-22
- Last updated
- 2025-12-05
- Certified
- 2025-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.