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

Moscow Medical, PA

Organization Family Medicine Physician · NPI 1871646976

Moscow Medical, PA is a Family Medicine Physician in Moscow, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

213 N Main St
Moscow, ID 83843-2700
Phone: (208) 882-7565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (ID)

Record details

NPI number1871646976
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kathy Cornish — Billing Manager · (208) 746-3653
NPI enumeratedJanuary 19, 2007
Last updated in NPPESMarch 31, 2009
Mailing address213 N Main St, Moscow, ID 83843-2700

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