ROBERT WASSERSTROM (NPI# 1982638037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982638037 |
| Entity Type | Individual |
| Full Name | ROBERT WASSERSTROM |
| Credential | M.D. |
| Practice Address |
260 Falls Ave Twin Falls ID 83301-3370 |
| Mailing Address |
Po Box 9649 Boise ID 83707-4649 |
| Practice Telephone | 2087372192 |
| Mailing Telephone | 2084728102 |
| Mailing Fax Number | 2083441926 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M6483 | ID | Allopathic & Osteopathic Physicians |
| Street Address |
260 FALLS AVE |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-3370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356314843 | Jeremy David Willes | Physician Assistant | 260 Falls Ave, Suite C, Twin Falls, ID 83301-3370 | 2006-02-07 |
| 1952458127 | Chad J Nielson | Chiropractor | 260 Falls Ave, Suite B, Twin Falls, ID 83301-3370 | 2007-01-03 |
| 1447284591 | Evan D Thomas | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-07-11 |
| 1245264399 | Michael P Dixon | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-07-11 |
| 1255361150 | Michael E Holzer | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-07-04 |
| 1902842271 | Terry J Buccambuso | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-06-22 |
| 1295771129 | Southern Idaho Radiology Pa | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558724070 | Allied Portable Xray Inc | Radiology | 1255 Filer Ave E Ste C, Twin Falls, ID 83301-4118 | 2016-04-01 |
| 1477675726 | Joshua E Hall | Radiology | 650 Addison Ave W, Twin Falls, ID 83301-5444 | 2007-04-06 |
| 1447284591 | Evan D Thomas | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-07-11 |
| 1245264399 | Michael P Dixon | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-07-11 |
| 1255361150 | Michael E Holzer | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-07-04 |
| 1902842271 | Terry J Buccambuso | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-06-22 |
| 1295771129 | Southern Idaho Radiology Pa | Radiology | 260 Falls Ave, Twin Falls, ID 83301-3370 | 2006-06-20 |
| 1336111269 | Daniel Constantine Alder | Radiology | 650 Addison Ave W, Radiology Department, Twin Falls, ID 83301-5444 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518597285 | Katie Clegg | Radiology | 593 W 24th St, Burley, ID 83318-2803 | 2020-01-22 |
| 1376920553 | Creighton Lewis | Radiology | 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 | 2015-04-27 |
| 1598176448 | Derek A Khorsand | Radiology | Kootenai Health, 2003 Kootenai Way, Coeur D'alene, ID 83814 | 2014-05-14 |
| 1578903191 | Miriam Bryna Hulkower | Radiology | 1839 N Govt Way Ste B, Coeur D Alene, ID 83814-3454 | 2013-06-27 |
| 1750647913 | Philip John Dougherty | Radiology | 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 | 2012-04-02 |
| 1356510143 | Newell Kay Richardson | Radiology | 2088 E 49th South, Idaho Falls, ID 83404-7649 | 2008-02-26 |
| 1477733574 | Cameron J Evans | Radiology | 4121 N 2600 E, Filer, ID 83328-5155 | 2007-11-06 |
| 1295926061 | Michael Modica | Radiology | 877 W Main St, Suite 603, Boise, ID 83702-5883 | 2007-08-07 |
| 1972709590 | Stephen Arthur Sherman | Radiology | 4685 Flora Dr, Pocatello, ID 83204-4568 | 2007-06-21 |
| 1891999165 | Vidvuds Bandrevics | Radiology | 102 Canyon Rd, Hailey, ID 83333-5067 | 2007-06-12 |
| Find all providers with the same taxonomy | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.