Provider Demographics
NPI:1619974441
Name:NEHER, RICHARD G (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:NEHER
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 1:502 N SECOND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1558
Mailing Address - Country:US
Mailing Address - Phone:208-263-1421
Mailing Address - Fax:208-263-4430
Practice Address - Street 1:502 N SECOND AVE STE 3
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1558
Practice Address - Country:US
Practice Address - Phone:208-263-1421
Practice Address - Fax:208-263-4430
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM4333208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0059857Medicaid
WA1012293Medicaid
ID000010005773Medicare UPIN
ID42069Medicare UPIN
MT0059857Medicaid
WA1012293Medicaid