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Individual

MRS. ELAINE M. DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2840 S MERIDIAN RD, MERIDIAN, ID 83642-7960
(208) 593-6393
(208) 593-6402
Mailing address
2840 S MERIDIAN RD, MERIDIAN, ID 83642-7960
(208) 593-6393
(208) 593-6402

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5546
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010150633
BLUE SHIELD
ID
05
003656100
ID
01
74526
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
09/09/2025
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