Individual
DAVID B SOUVENIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 750-7204
(208) 746-0134
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 750-7204
(208) 746-0134
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M9267
ID
207RI0200X
Infectious Disease Physician
Primary
M-9267
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807175200
—
ID
Enumeration date
08/03/2006
Last updated
02/15/2019
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