Provider Demographics
NPI:1235133844
Name:DENYER, MICHAEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:DENYER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2225 TETON PLZ
Mailing Address - Street 2:STE B
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6494
Mailing Address - Country:US
Mailing Address - Phone:208-524-4660
Mailing Address - Fax:208-524-4617
Practice Address - Street 1:2225 TETON PLZ
Practice Address - Street 2:STE B
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6494
Practice Address - Country:US
Practice Address - Phone:208-524-4660
Practice Address - Fax:208-524-4617
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2010-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM7194208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDB66222Medicare UPIN