Souvenir, David B

Souvenir, David B is an individual health care provider with primary practice located at 415 6Th St , Lewiston ID 83501-2431. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Souvenir, David B can be contacted via phone (208) 750-7204.

Contact Information

Primary practice address
415 6Th St Lewiston ID 83501-2431
Phone: (208) 750-7204
Fax: (208) 746-0134
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X M9267 Idaho
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X M-9267 Idaho

Profile Details

NPI number 1023026457
LBN Legal business name Souvenir, David B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Feb 15th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023026457 NPPES
Idaho MEDICAID 807175200

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