Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Moscow Medical, PA

Organization Family Medicine Physician · NPI 1871646976

Moscow Medical, PA provides Family Medicine Physician services 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 Not confirmed with CMS for 17 years — call before visiting
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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