Provider Demographics
NPI:1508205493
Name:KARLFELDT, MICHAEL ROLF (PHD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROLF
Last Name:KARLFELDT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1715
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83701-1715
Mailing Address - Country:US
Mailing Address - Phone:208-338-8902
Mailing Address - Fax:208-693-8456
Practice Address - Street 1:5010 W CASSIA ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1949
Practice Address - Country:US
Practice Address - Phone:208-338-8902
Practice Address - Fax:208-693-8456
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath