Provider Demographics
NPI:1326106279
Name:PUFFER, STEVEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:PUFFER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6635 COMANCHE ST
Mailing Address - Street 2:PO BOX Q
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-7523
Mailing Address - Country:US
Mailing Address - Phone:208-267-1718
Mailing Address - Fax:208-267-7739
Practice Address - Street 1:1327 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1735
Practice Address - Country:US
Practice Address - Phone:208-263-7101
Practice Address - Fax:208-263-7198
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM-3276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806590100Medicaid
ID806590100Medicaid
B36807Medicare UPIN
ID131832Medicare Oscar/Certification