Search icon

ASSOCIATED INTERNAL MEDICINE, P.A.

Company claim

Is this your business?

Get access!

Company Details

Name: ASSOCIATED INTERNAL MEDICINE, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 30 Dec 1997 (28 years ago)
Financial Date End: 31 Dec 2017
Date dissolved: 27 Mar 2018
Entity Number: 374891
Place of Formation: IDAHO
File Number: 0000374891
ZIP code: 83814
County: Kootenai County
Mailing Address: 2207 IRONWOOD PL COEUR D'ALENE, ID 83814

National Provider Identifier

NPI Number:
1699805994

Authorized Person:

Name:
DR. SUSAN MARIE DAUGHARTY FOWLER
Role:
MD OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No

Contacts:

Fax:
2086673994

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0002606979 2016-03-31
Application for Reinstatement 0000876088 2016-03-30
Annual Report 0002606978 2015-01-14
Application for Reinstatement 0002606977 2013-03-28
Application for Reinstatement 0000876087 2013-03-22

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State