Provider Demographics
NPI:1922360379
Name:SCHOO, CAROLINE BONAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:BONAIRE
Last Name:SCHOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 N RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9251
Mailing Address - Country:US
Mailing Address - Phone:208-514-2500
Mailing Address - Fax:
Practice Address - Street 1:215 E HAWAII AVE STE 140
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-6011
Practice Address - Country:US
Practice Address - Phone:208-514-2529
Practice Address - Fax:208-375-2217
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO54726207Q00000X, 208M00000X
IDM-16046207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0054726Medicaid
IDM12236OtherID LICENSE
CO028795OtherKAISER COMMERCIAL NUMBER