| Pmg Mt Montana Internal Med | |
|
2819 Great Northern Loop Suite 200 Missoula MT 59808-1750 | |
| (406) 543-1197 | |
| (406) 543-0515 |
| Full Name | Pmg Mt Montana Internal Med |
|---|---|
| Speciality | Internal Medicine |
| Location | 2819 Great Northern Loop, Missoula, Montana |
| Authorized Official Name and Position | Kirk Bodlovic (CFO) |
| Authorized Official Contact | 4063271918 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmg Mt Montana Internal Med Po Box 12 Liberty Lake WA 99019-0012 Ph: (406) 327-1918 | Pmg Mt Montana Internal Med 2819 Great Northern Loop Suite 200 Missoula MT 59808-1750 Ph: (406) 543-1197 |
| NPI Number | 1730325440 |
|---|---|
| Provider Enumeration Date | 12/30/2008 |
| Last Update Date | 11/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730325440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0411866 (Montana) | Primary |
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