Provider Demographics
NPI:1073523460
Name:NEFF, TERENCE EARL (MD)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:EARL
Last Name:NEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:700 W IRONWOOD DR
Mailing Address - Street 2:SUITE 155
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2656
Mailing Address - Country:US
Mailing Address - Phone:208-667-0585
Mailing Address - Fax:208-667-0876
Practice Address - Street 1:700 W IRONWOOD DR
Practice Address - Street 2:SUITE 155
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2656
Practice Address - Country:US
Practice Address - Phone:208-667-0585
Practice Address - Fax:208-667-0876
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM4886208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010004636OtherREGENCE BLUE SHIELD
WA1011386Medicaid
ID48868OtherBLUE CROSS OF IDAHO
IDDF482OtherBLUE CROSS OF IDAHO
ID000010004635OtherREGENCE BLUE SHIELD
ID002584700Medicaid
ID000010004636OtherREGENCE BLUE SHIELD
ID48868OtherBLUE CROSS OF IDAHO