| Dr Robert Lantz Davidson, MD | |
| 3525 E Louise Dr Ste 195, Meridian, ID 83642 | |
| (208) 846-8335 | |
| (208) 846-8336 | 
| Full Name | Dr Robert Lantz Davidson | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine - Nephrology | 
| Location | 3525 E Louise Dr Ste 195, Meridian, Idaho | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144275694 | NPI | - | NPPES | 
| 003661400 | Medicaid | ID | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207RN0300X | Internal Medicine - Nephrology | M7907 (Idaho) | Primary | 
| 174400000X | Specialist | M7907 (Idaho) | Secondary | 
| Entity Name | St Lukes Clinic-treasure Valley Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Robert Lantz Davidson, MD 3525 E Louise Dr Ste 195, Meridian, ID 83642-6303 Ph: (208) 846-8335 | Dr Robert Lantz Davidson, MD 3525 E Louise Dr Ste 195, Meridian, ID 83642 Ph: (208) 846-8335 | 
| Mr. Eric Ld Scholten, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2347 E Gala St, Meridian, ID 83642 Phone: 208-323-3767 Fax: 208-323-3768 | |
| Lynn Ge-zerbe, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 1759 S Millenium Way, Meridian, ID 83642 Phone: 208-387-6546 Fax: 888-334-8747 | |
| Dr. Tomoki Sempokuya, M.D. Nephrology Medicare: Medicare Enrolled Practice Location: 3277 E Louise Dr, Meridian, ID 83642 Phone: 208-706-5127 Fax: 208-706-5854 | |
| Dr. Aaron Dunham, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3025 W Cherry Lane, Ste 204, Meridian, ID 83642 Phone: 208-302-3300 Fax: 208-302-3355 | |
| Oleg Sergeevich Kouskov, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2347 E Gala St, Meridian, ID 83642 Phone: 208-323-3767 | |
| John T Witte, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 2235 E Gala St, Meridian, ID 83642 Phone: 208-887-3724 Fax: 208-887-3724 | |
| Liang Wu, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3525 E Louise Dr Ste 100, Meridian, ID 83642 Phone: 208-999-0356 |