Provider Demographics
NPI:1821101395
Name:CINDRICH, PATRICK JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:CINDRICH
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 1:1218 9TH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:RUPERT
Mailing Address - State:ID
Mailing Address - Zip Code:83350-2207
Mailing Address - Country:US
Mailing Address - Phone:208-434-8480
Mailing Address - Fax:208-436-3956
Practice Address - Street 1:1218 9TH ST STE 10
Practice Address - Street 2:
Practice Address - City:RUPERT
Practice Address - State:ID
Practice Address - Zip Code:83350-2207
Practice Address - Country:US
Practice Address - Phone:208-436-0481
Practice Address - Fax:208-436-3956
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11999207T00000X
IDM4548207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110392101OtherFIRSTCARE
TX0010HHOtherBLUE CROSS BLUE SHIELD
TX10734979OtherUNITED HEALTHCARE
TX140007901OtherRAILROAD MEDICARE
TX153394501Medicaid
TXD93697Medicare UPIN
TN00364TMedicare ID - Type Unspecified