Provider Demographics
NPI:1740232248
Name:RICE, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2855 E MAGIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6245
Mailing Address - Country:US
Mailing Address - Phone:208-639-4900
Mailing Address - Fax:208-639-4901
Practice Address - Street 1:1211 24TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2562
Practice Address - Country:US
Practice Address - Phone:360-299-4980
Practice Address - Fax:360-299-4269
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-7104208800000X
WAMD61167592208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1740232248Medicaid
ID1740232248Medicaid
IDP00247656OtherRAILROAD MEDICARE
IDG42524Medicare UPIN
ID80407400Medicaid
ID1135143Medicare ID - Type Unspecified