Grace Marie Cobiella, M.D.
Individual provider Active NPI Psychiatry Physician · Idaho Falls, ID
NPI 1740325083 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1740325083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- M6214 (ID)
- Practice address
- 3100 Channing Way
Idaho Falls, ID 83404-7533 - Phone
- (208) 227-2100
- Fax
- (208) 227-2361
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6214 | ID | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M6214 | ID | Yes |
Addresses
Primary practice location
3100 Channing Way
Idaho Falls, ID 83404-7533
Mailing address
3100 Channing Way
P.O. Box 2077
Idaho Falls, ID 83404-7533
Phone (208) 227-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0036361 | Medicaid | ID |
Other providers in Idaho Falls, ID
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- Clubhouse Pediatric Dentistry of Idaho Falls
- Jeffrey Bennion Cockayne
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- Cole Vision Corporation
- Bradley Cole
- Kelsey Lynn Cole
All providers in Idaho Falls, ID · Psychiatry Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.