Daniel Brodie McIntosh, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M5406 Issued in ID

Practice address

307 Saint Johns Way
Ste #9
Lewiston, ID 83501-2435

Phone

(208) 746-7055

Fax

(208) 746-4899

NPI assigned

Jun 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801831151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 SAINT JOHNS WAY",
            "address_2": "STE #9",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012435",
            "telephone_number": "208-746-7055",
            "fax_number": "208-746-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 SAINT JOHNS WAY",
            "address_2": "STE #9",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012435",
            "telephone_number": "208-746-7055",
            "fax_number": "208-746-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "DANIEL",
        "middle_name": "BRODIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M5406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "000010005765",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "54064",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000826400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Mayer, PHARMD
• Amanda Marie McGehee, PHARM. D.
• Linda Louise McGrale, LICENSED MASSAGE PRA
• Maree P McHugh, FNP
• Brandon McIntosh, LCSW
• Brenda McKenzie, MS, MED, LPC
• Amber Christine McKinney, PA-C
• Tony Devaun McNeil
• Mary McPherson
• Karen Meadows, MED

• Internal Medicine Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.