Robert L. Davidson, M.D. PLLC
Internal Medicine, Nephrology in Meridian, ID. Organization (NPI-2).
NPI number1124357645
StatusActive
Last updated in NPPESDec 11, 2009
Details
- NPI
- 1124357645
- Entity type
- Organization (NPI-2)
- Legal business name
- Robert L. Davidson, M.D. PLLC
- Organization subpart
- No
- Enumeration date
- Dec 11, 2009
- Last updated
- Dec 11, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | M7907 | ID | Yes |
Practice location
520 S Eagle RdSuite 1245
Meridian, ID 83642-6351
Phone 208-890-2539 · Fax 208-939-2698
Mailing address
13601 W McMillan RdSuite 102-311
Boise, ID 83713-2071
Phone 208-890-2539 · Fax 208-939-2698
Authorized official
Robert Lantz Davidson
Physician Owner
2088909539
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