LAURA M WIKE (NPI# 1174589543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174589543 |
| Entity Type | Individual |
| Full Name | LAURA M WIKE |
| Credential | MD |
| Practice Address |
2517 N Cisco Ln Boise ID 83702-5502 |
| Practice Telephone | 9525951301 |
| Practice Fax Number | 6122944903 |
| Mailing Telephone | 9525951301 |
| Mailing Fax Number | 6122944903 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-9158 | ID | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
31652 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
2517 N CISCO LN |
| City | BOISE |
| State | ID |
| Zip Code | 83702-5502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376920553 | Creighton Lewis | Radiology | 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 | 2015-04-27 |
| 1295926061 | Michael Modica | Radiology | 877 W Main St, Suite 603, Boise, ID 83702-5883 | 2007-08-07 |
| 1346457298 | John Charles Kirkham | Radiology | 115 W Main St Ste 202, Boise, ID 83702-7303 | 2007-05-17 |
| 1811046386 | Frank J Daniels | Radiology | 5122 S Surprise Way Apt 202, Boise, ID 83716-9050 | 2007-01-10 |
| 1821039025 | Michael J Ryan | Radiology | 232 S Whisperwood Way, Boise, ID 83709-4900 | 2006-06-09 |
| 1679513303 | Intermountain Medical Imaging LLC | Radiology | 161 E Mallard Dr, Suite 120, Boise, ID 83706-5015 | 2006-06-08 |
| 1669423679 | Intermountain Medical Imaging LLC | Radiology | 927 W Myrtle St, Boise, ID 83702-7061 | 2006-05-15 |
| 1922077635 | Ryan Slaughter | Radiology | 907 Harrison Blvd, Boise, ID 83702-4052 | 2006-03-15 |
| 1336554740 | Geoffry De Gennaro Jr. | Radiology | 190 E Bannock St, Boise, ID 83712-6241 | 2014-06-24 |
| 1760825442 | Jason Gary Hamblin | Radiology | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2013-04-11 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.