Individual
TARA MARIE DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
(208) 381-4025
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30238
MN
207R00000X
Internal Medicine Physician
67727
MN
207R00000X
Internal Medicine Physician
Primary
U2470
TX
207RX0202X
Medical Oncology Physician
7271557
ID
Other
Enumeration date
04/22/2019
Last updated
09/11/2025
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