Provider Demographics
NPI:1184645517
Name:HENBEST, MICHAEL L (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:HENBEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6140 CURTISIAN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8880
Mailing Address - Country:US
Mailing Address - Phone:208-367-3500
Mailing Address - Fax:208-367-2968
Practice Address - Street 1:6140 CURTISIAN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8880
Practice Address - Country:US
Practice Address - Phone:208-367-3500
Practice Address - Fax:208-367-2968
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM5080207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
202653500OtherUS DEPARTMENT OF LABOR
ID002603900Medicaid
WA13OtherWA DEPARTMENT OF LABOR
OR198077OtherOMAP
ID74302OtherBLUE CROSS OF IDAHO
ID000010004343OtherREGENCE BLUE SHIELD
OR198077OtherOMAP
ID002603900Medicaid
ID74302OtherBLUE CROSS OF IDAHO