Individual
BRENDA S DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
315 E ELM ST, SUITE 310, CALDWELL, ID 83605-4857
(208) 454-2035
(208) 454-1065
Mailing address
3520 E. LOUISE DR, MERIDIAN, ID 83642
(208) 955-0350
(208) 955-0352
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G05134
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010001161
REGENCE BLUE SHIELD OF ID
ID
05
—
003658200
—
ID
01
—
15024
BLUE CROSS OF IDAHO
ID
05
—
207527
—
OR
Enumeration date
01/24/2006
Last updated
08/04/2009
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