Individual
DR. CHARLES MICHAEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W. FORT ST., # 111, BOISE, ID 83702
(208) 422-1325
(208) 422-1319
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O--0448
ID
Other
Enumeration date
05/13/2006
Last updated
02/25/2022
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