Most Relevant Information
Provider Data
| NPI Number: | 1003003062 |
| Provider Name: | FATIMA WALIZADA |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | P6086 |
Most Important Dates
| Enumeration Date: | 10/03/2007 |
| Last Updated: | 10/03/2007 |
Provider Practice Location
5005 W OVERLAND RD
BOISE
ID
837052633
Practice Location Phone/Fax
| Phone: | 2083891448 |
| Fax: |
Provider Mailing Location
5005 W OVERLAND RD
BOISE
ID
837052633
Provider Mailing Phone/Fax
| Phone: | 2083891448 |
| Fax: |