Provider Demographics
NPI:1134146129
Name:ALBRECHT, WARREN E (DO)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:E
Last Name:ALBRECHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3270 E 17TH ST STE 217
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-6758
Mailing Address - Country:US
Mailing Address - Phone:208-528-1000
Mailing Address - Fax:208-528-1900
Practice Address - Street 1:2985 CORTEZ AVE STE 200
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7554
Practice Address - Country:US
Practice Address - Phone:208-528-1000
Practice Address - Fax:208-528-1900
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND97262086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I11419Medicare UPIN