Matthew Davis, MD
Family Medicine in Boise, ID. Individual provider (NPI-1).
NPI number1982194973
StatusActive
Last updated in NPPESMay 15, 2018
Details
- NPI
- 1982194973
- Entity type
- Individual (NPI-1)
- Name
- Matthew Davis
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 15, 2018
- Last updated
- May 15, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | MRM-1725 | ID | Yes |
Practice location
777 N Raymond StBoise, ID 83704-9251
Phone 208-514-2500 · Fax 208-375-2217
Mailing address
777 N Raymond StBoise, ID 83704-9251
Phone 208-514-2500 · Fax 208-375-2217
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