Michael R Dibenedetto Md Pllc
Orthopaedic Surgery Clinic
30544 Hwy 200, Ste 102, Ponderay
Idaho, 83852
208-265-9836 208-263-7249
Maps & DirectionsMichael R Dibenedetto Md Pllc is a Clinic/center (Rehabilitation, Cardiac Facilities) Clinic in Ponderay, Idaho. It is situated at 30544 Hwy 200, Ste 102, Ponderay and its contact number is 208-265-9836. The authorized person of Michael R Dibenedetto Md Pllc is Mr. Daniel P Garman
who is Practice Manager of the clinic and their contact number is 208-265-9817.
Michael R Dibenedetto Md Pllc Clinic Definition to come...
Complete Profile:
Michael R Dibenedetto Md Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Specialization: | Rehabilitation, Cardiac Facilities, Clinic/center |
| Clinic Address: | 30544 Hwy 200, Ste 102, Ponderay,
Idaho, 83852 |
| Phone: | 208-265-9836 |
| Fax: | 208-263-7249 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Daniel P Garman |
| Position: | Practice Manager |
| Contact Number: | 208-265-9817 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Michael R Dibenedetto Md Pllc Clinic are as mentioned below.
| NPI Number: | 1083809727 |
| NPI Enumeration Date: | 06 Sep, 2007 |
| NPI Last Update On: | 07 May, 2021 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Michael R Dibenedetto Md Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Orthopaedic Surgery | | | Primary | |
| Rehabilitation, Cardiac Facilities | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| DG3627 | Other | Idaho | Palmetto Gba Railroad Med |
| 806452000 | Medicaid | Idaho | |
| 000010140056 | Other | Idaho | Regence Blue Shield |
| 8N259 | Other | Idaho | Blue Cross |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Michael R Dibenedetto Md Pllc
30544 Hwy 200, Ste 102
Ponderay, Idaho |
| Zip: | 83852 |
| Phone Number: | 208-265-9817 |
| Fax Number: | 208-263-7249 |
Patients can reach Michael R Dibenedetto Md Pllc at
30544 Hwy 200, Ste 102, Ponderay, Idaho or can
call to book an appointment on 208-265-9836.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.