MARK KIECKBUSCH, M.D.

Pathology - Anatomic Pathology & Clinical Pathology

Active Individual
NPI: 1215981410

Practice Address

190 E BANNOCK ST
Boise, ID 83712

Phone: (208) 381-2367

Specialties

Specialty Code Primary License
Pathology - Anatomic Pathology & Clinical Pathology 207ZP0102X Yes M6070 (ID)
Pathology - Hematology 207ZH0000X No M6070 (ID)

Frequently Asked Questions

NPI 1215981410 is the National Provider Identifier for MARK KIECKBUSCH, M.D., a Pathology - Anatomic Pathology & Clinical Pathology provider located in Boise, ID. This NPI was enumerated on May 20, 2006.
MARK KIECKBUSCH, M.D. practices at 190 E BANNOCK ST, Boise, ID 83712.

Quick Facts

NPI
1215981410
Type
Individual
Enumerated
May 20, 2006
Last Updated
Dec 11, 2007

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