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1104877364
CHARLES MICHAEL DAVIS
BOISE, ID
NPI
1104877364
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID O--0448)
Enumeration Date
2006-05-13
Last Update Date
2022-02-25
Business Address
DR. CHARLES MICHAEL DAVIS DO
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
DR. CHARLES MICHAEL DAVIS DO
500 W. FORT ST. # 111
BOISE, ID 83702
Phone number: 208-422-1325
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