Provider Demographics
NPI:1548214265
Name:MINGS, STEVEN M (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:MINGS
Suffix:
Gender:M
Credentials:MD
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 1603
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-1603
Mailing Address - Country:US
Mailing Address - Phone:208-424-9101
Mailing Address - Fax:208-424-5072
Practice Address - Street 1:388 E. PARKCENTER BLVD.
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706
Practice Address - Country:US
Practice Address - Phone:208-424-9101
Practice Address - Fax:208-424-5072
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM7247207N00000X
IDPA377363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
G56246Medicare UPIN