Individual
MR. GEORGE BANDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W BROADWAY ST STE 320, MISSOULA, MT 59802-4003
(406) 329-5615
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 329-5615
(406) 329-5606
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
M-8273
ID
207RC0000X
Cardiovascular Disease Physician
Primary
MED-PHYS-LIC-9853
MT
207RI0011X
Interventional Cardiology Physician
9853
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67388
—
MT
01
—
96485
BLUE CROSS/BLUE SHIELD
MT
01
—
A002
TRICARE
MT
01
—
P00062024
RAIL ROAD MEDICARE
MT
Enumeration date
05/08/2006
Last updated
10/08/2024
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