Individual
EDWARD D DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
323 E RIVERSIDE DR STE 224, EAGLE, ID 83616-6865
(208) 302-6000
(208) 302-6055
Mailing address
323 E RIVERSIDE DR STE 224, EAGLE, ID 83616-6865
(208) 302-6000
(208) 302-6055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MC-1136
ID
207R00000X
Internal Medicine Physician
MD00028087
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2110721
—
WA
Enumeration date
06/12/2006
Last updated
07/24/2024
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