Individual
DR. ROBERT LANTZ DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3525 E LOUISE DR STE 195, MERIDIAN, ID 83642
(208) 846-8335
(208) 846-8336
Mailing address
3525 E LOUISE DR STE 195, MERIDIAN, ID 83642-6303
(208) 846-8335
(208) 846-8336
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
M7907
ID
207RN0300X
Nephrology Physician
Primary
M7907
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003661400
—
ID
Enumeration date
05/23/2006
Last updated
05/16/2018
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