Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coeur D'Alene Surgical and Vein

Organization Medical Specialty Clinic/Center · NPI 1225368632

Coeur D'Alene Surgical and Vein is a Medical Specialty Clinic/Center in Coeur D Alene, Idaho. Licensed in Idaho. Registered with an NPI since 2010.

Licensed in
ID
In the registry since
2010

Practice location Address checks out

608 NW Blvd Ste 301
Coeur D Alene, ID 83814-2174
Phone: (208) 664-4940
Fax: (208) 664-5345
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence M-7963 (ID)

Record details

NPI number1225368632
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Johnson — Managing Member · (208) 664-4940
NPI enumeratedJanuary 6, 2010
Last updated in NPPESMarch 20, 2013
Mailing address608 Northwest Blvd, Suite 301, Coeur D Alene, ID 83814-2174

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